AAPC Official CPC
Certification Study Guide
Notes Exam Questions
and Certified Solutions
Graded A+
Denning [Date] [Course title]
,"hold harmless clause" - Answer: * found in some non-Medicare health plan contracts
* prohibits billing to patient for anything beyond deductibles and co-pays.
A compliance plan may offer several benefits, including: - Answer: * more accurate payment of claims
* fewer billing mistakes
* improved documentation and more accurate coding
* less chance of violating self-referral and anti-kickback status
A healthcare clearing house is a - Answer: entity that processes nonstandard health information they
receive from another entity into a standard format
A key provision in HIPAA is the Minimum Necessary requirement. this means - Answer: only the
minimum necessary protected health information should be shared to satisfy a particular purpose.
A medically necessary service is the - Answer: least radical service/procedure that allows for effective
treatment of the patients' complaint or condition
A patient sustaining an injury to her great saphenous vein would have sustained injury to which of
anatomical site? - Answer: Leg
APC - Answer: Ambulatory Payment Classification
ARRA - Answer: American Recovery and Reinvestment Act (of 2009)
ASC - Answer: Ambulatory Surgical Centers
Abuse consists of - Answer: payment for items or services that are billed by providers in error that
should not be paid for by Medicare.
, An ABN protects the provider's financial interest by - Answer: creating a paper trail that CMS requires
before a provider can bill the patient for payment if Medicare denies coverage for the stated service or
procedure.
An entity that processes nonstandard health information they receive from another entity into a
standard format is considered what? - Answer: Clearinghouse
As a part of Health Care Reform, the Affordable Care Act of 2010 amended the definition of fraud to
remove the __________ requirement - Answer: intent
By statute, all work RVUs, must be examined no less often than - Answer: every 5 years
CF - Answer: Coversion Factor - fixed dollar amount used to translate the RVUs into fees
CMS - Answer: Centers for Medicare and Medicaid
CMS developed polices regarding medical necessity are based on regulations found in title XVIII,
$1862(a) of the - Answer: Social Security Act
CMS will accept the ____________ for either a "potentially non=covered" service or for a statutorily
excluded service - Answer: CMS-R-131
CMS-R-131 - Answer: ABN form
or
Advance Beneficiary Notice which explains to the patient why Medicare may deny the particular service
or procedure.
CPT - Answer: Current Procedural Terminology
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