AAPC - Chapter 1: Practical Application Exam Questions 2024/2025

What type of profession, other than coding, might skilled coders enter? Consultants, educators, medical auditors What is the difference between outpatient and inpatient coding? Outpatient coding focuses on physician services. Outpatient coders focus on assigning CPT, HCPCS Level II, and ICD-10-CM codes. They work in provider offices, outpatient clinics and facility outpatient departments. Outpatient facility coders also work with ambulatory payment classifications (APCs). Inpatient hospital coding focuses on a different subset of skills, where coders work with ICD-10-CM and ICD-10-PCS. These coders also assign Medicare severity-diagnosis related groups (MS-DRGs) for reimbursement. Outpatient coders usually will have more interaction throughout the day and must communicate well with providers; inpatient coders tend to have less interaction throughout the day. What is a mid-level provider? Mid-level providers include physician assistants (PA) and nurse practitioners (NP). What are the different parts of Medicare? Part A, B, C, D Evaluation and management (E/M) services are often provided and documented in a standard format. One such format is SOAP notes. What does SOAP represent? Subjective, Objective, Assessment, Plan What are five tips for coding operative (op) reports? Diagnosis code reporting, Start with the procedures listed, Look for key words, Highlight unfamiliar words, Read the body What is medical necessity? Relates to whether a procedure or service is considered appropriate in a given circumstance. What is not a common reason Medicare may deny a procedure or service? Covered service. Medicare doesn't pay for the procedure/service to treat the patient's condition, the procedure/service as frequently as proposed or for experimental procedures/services.