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AAPC CPC Chapter 1 Exam questions with answers
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What does MAC stands for? ✔Medicare Administrative Contractor Which coding manuals do outpatient coders focus on learning? ✔CPT®, HCPCS Level II and ICD-10-CM In what year was the AAPC founded? ✔ 1988 What type of provider goes through approximately 26 1⁄2 months of education and is licensed to practice medicine with the oversight of a physician? ✔Physician Assistant (PA) In what year did HIPAA become law? ✔ 1996 Which type of information is NOT maintained in a medical record? ✔Financial Records The minimum necessary rule is based on sound current practice that protected health information should NOT be used or disclosed when it is not necessary to satisfy a particular purpose or carry out a function. What does this mean? ✔Providers should develop safeguards to prevent unauthorized access to protected health information. If an NCD does not exist for a particular service/procedure performed on a Medicare patient, who determines coverage? ✔Medicare Administrative Contractor (MAC) Professionals who specialize in coding are called:q ✔Coding specialists In what year was HITECH enacted as part of the American Recovery and Reinvestment Act? ✔ 2009
LCDs only have jurisdiction in their ____. ✔Region How many components are included in an effective compliance plan? ✔ 7 Many coding professionals go on to find work as: ✔Consultants The Medicare program is made up of several parts. Which part is affected by the Centers for Medicare & Medicaid Services - Hierarchical Condition Categories (CMS-HCC)? ✔Part C According to AAPC's Code of Ethics, an AAPC member shall use only ____ and ____ means in all professional dealings. ✔Legal and Ethical What is the value of a remittance advice? ✔It states what will be paid and why any changes to charges were made. AAPC credentialed coders have proven mastery of what information? ✔All code sets, evaluation & management principles, and documentation guidelines Evaluation and management services are often provided in a standard format such as SOAP notes. What does the acronym SOAP stand for? ✔Subjective, Objective, Assessment, Plan HITECH provides a ____ day window during which any violation not due to willful neglect may be corrected without penalty. ✔ 30 What form is used to submit a provider's charge to the insurance carrier? ✔CMS- Voluntary compliance programs also provide benefits by not only helping to prevent erroneous or ____, but also by showing that the provider practice is making additional good faith efforts to submit claims appropriately.
Under HIPAA, would would be a policy requirement of MINIMUM NECESSARY? A.) Only individuals whose job requires it may have access to protected health information. B.) Only the patient has access to his or her own PHI C.) Only the treating provider has access to PHI. D.) Anyone within the provider's office can have access to PHI. ✔A Which act was enacted as part of the American Recovery and Reinvestment Act of 2009 (ARRA) and affected privacy and security? ✔HITECH What document assists provider offices with the development of compliance manuals? ✔OIG Compliance Program Guidance What document is referenced when looking for potential problem areas identified by the government indicating scrutiny of the services? ✔OIG Work Plan ABN ✔Advanced Beneficiary Notice AMA ✔American Medical Association APC ✔Ambulatory Payment Classification ARRA ✔American Recovery and Reinvestment Act of 2009 ASC ✔Ambulatory Surgical Center CDT ✔Current Dental Terminology
✔Centers for Medicare and Medicaid Services CMS-HCC ✔Centers for Medicare & Medicaid Services-Hierarchical Condition Category CPC ✔Certified Professional Coder CPT ✔Current Procedural Terminology EHR ✔electronic health record EIN ✔Employer Identification Number E/M ✔Evaluation and Management HCPCS ✔Healthcare Common Procedure Coding System HHS ✔Department of Health and Human Services HIPAA ✔Health Insurance Portability and Accountability Act of 1996 HITECH ✔Health Information Technology for Economic and Clinical Health Act HMO ✔health maintenance organization ICD-10-CM
✔Physician extenders such as PA & NP What are the different parts of Medicare and what do they cover? ✔Part A: Inpatient Care Part B: Outpatient Care Part C: MCR Advantage plans Pard D: Prescriptions What are common reasons Medicare may deny a procedure or service? ✔1. Diagnosis/Condition
✔Treatment, payment, and healthcare operations