CPC FINAL EXAM PREP QUESTIONS 2022/2023
• Question 1
10 out of 10 points
What form is provided to a patient to indicate a service may not be covered by Medicare and the patient may be responsible for the charges?
Selected d.
Answer: ABN
Correct d.
Answer: ABN
Response Ra...
cpc final exam prep questions 20222023 • question 1 10 out of 10 points what form is provided to a patient to ind
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CPC FINAL EXAM PREP QUESTIONS 2022/2023
• Question 1
10 out of 10 points
What form is provided to a patient to indicate a service may not be covered by Medicare and the
patient may be responsible for the charges?
Selected d.
Answer: ABN
Correct d.
Answer: ABN
Response Rationale: An Advanced Beneficiary Notice (ABN) is used when a Medicare Feedback:
beneficiary requests or agrees to receive a procedure or service that Medicare may not cover. This
form notifies the patient of potential out of pocket costs for the patient.
• Question 2
10 out of
10 points
Which statement describes a medically necessary service?
Selected b.
Answer: Using the least radical service/procedure that allows for effective treatment of the
patient’s complaint or condition. b.
Correct Using the least radical service/procedure that allows for effective treatment of the
Answer: patient’s complaint or condition.
Rationale: Medical necessity is using the least radical services/procedure that allows
Response for effective treatment of the patient’s complaint or condition.
Feedback:
• Question 3
10 out of
10 points What document assists provider offices with the development of Compliance Manuals?
Selected a.
Answer: OIG Compliance Plan Guidance
Correct a.
Answer: OIG Compliance Plan Guidance
Response Rationale: The OIG has offered compliance program guidance to form the Feedback:
basis of a voluntary compliance program for physician offices. Although this was released in
October 2000, it is still active compliance guidance today.
• Question 4
10 out of
10 points
Under HIPAA, what would be a policy requirement for “minimum necessary”?
Selected a.
Answer: Only individuals whose job requires it may have access to protected health
information.
,CPC FINAL EXAM PREP QUESTIONS
Correct a.
Answer: Only individuals whose job requires it may have access to protected health
information.
Response Rationale: It is the responsibility of a covered entity to develop and implement
Feedback: policies, best suited to its particular circumstances to meet HIPAA requirements. As a
policy requirement, only those individuals whose job requires it may have access to
protected health information.
• Question 5
10 out of 10 points
According to the example LCD from Novitas Solutions, measurement of vitamin D levels is indicated
for patients with which condition?
Selected b.
Answer: fibromyalgi a
b.
Correct fibromyalgi a
Answer:
Rationale: According to the LCD, measurement of vitamin D levels is indicated
for patients with fibromyalgia.
Response
Feedback:
• Question 6
10 out of 10 points
Select the TRUE statement regarding ABNs.
Selected a.
Answer: ABNs may not be recognized by non-Medicare payers. a.
Correct ABNs may not be recognized by non-Medicare payers.
Answer:
Rationale: ABNs may not be recognized by non-Medicare payers. Providers should
Response review their contracts to determine which payers will accept an ABN for services not
Feedback: covered.
• Question 7
10 out of 10 points
Who would NOT be considered a covered entity under HIPAA?
Selected d. Answer:
Patients
Correct d.
Answer: Patients
Response Rationale: Covered entities in relation to HIPAA include Health Care Providers,
Feedback: Health Plans, and Health Care Clearinghouses. The patient is not considered a covered
entity although it is the patient’s data that is protected.
• Question 8
10 out of 10 points
When presenting a cost estimate on an ABN for a potentially noncovered service, the cost estimate
should be within what range of the actual cost?
Selected c.
Answer: $100 or 25 percent
Correct c.
, Answer: $100 or 25 percent
Response Rationale: CMS instructions stipulate, “Notifiers must make a good faith effort
Feedback: to insert a reasonable estimate…the estimate should be within $100 or 25 percent of the
actual costs, whichever is greater.”
• Question 9
10 out of 10 points
Which act was enacted as part of the American Recovery and Reinvestment Act of 2009
(ARRA) and affected privacy and security?
Selected b. Answer: HITECH
Correct b.
Answer: HITECH
Response Rationale: The Health Information Technology for Economic and Clinical Health
Feedback Act (HITECH) was enacted as a part of the American Recovery and
: Reinvestment Act of 2009 (ARRA) to promote the adoption and meaningful use
of health information technology. Portions of HITECH strengthen HIPAA rules by
addressing privacy and security concerns associated with the electronic transmission of
health information.
• Question 10
10 out of 10 points
What document is referenced to when looking for potential problem areas identified by the government indicating
scrutiny of the services within the coming year?
Selected c. Answer: OIG
Work Plan
Correct c.
Answer: OIG Work Plan
Response Rationale: Twice a year, the OIG releases a Work Plan outlining its priorities for
Feedback: the fiscal year ahead. Within the Work Plan, potential problem areas with claims
submissions are listed and will be targeted with special scrutiny.
Sunday, November 19, 2017 9:04:26 AM MST
•
The minimum necessary rule applies to
Selected b.
Answer:
Disclosures to or requests by a health care provider for treatment purposes.
Correct d.
Answer:
Covered entities taking reasonable steps to limit use or disclosure of PHI
• Response Rationale: The Privacy Rule generally requires covered entities to take
, CPC FINAL EXAM PREP QUESTIONS
Feedback reasonable steps to limit the use or disclosure of, and requests for, protected health
: information to the minimum necessary to accomplish the intended purpose. The
minimum necessary standard does not apply to the following: · Disclosures to or
requests by a health care provider for treatment purposes.
· Disclosures to the individual who is the subject of the information.
· Uses or disclosures made pursuant to an individual’s authorization. · Uses or
disclosures required for compliance with the Health Insurance Portability and
Accountability Act (HIPAA) Administrative Simplification Rules. · Disclosures to the
Department of Health & Human Services (HHS) when disclosure of information is
required under the Privacy Rule for enforcement purposes.
· Uses or disclosures that are required by other law.
Question 2
0 out of 4 points
According to the AAPC Code of Ethics, which term is NOT listed as an ethical principle of professional
conduct?
Selected d.
Answer: Commitmen t
Correct b.
Answer: Efficiency
Response Rationale: It shall be the responsibility of every AAPC member, as a condition
Feedback: of continued membership, to conduct themselves in all professional activities in a
manner consistent with ALL of the following ethical principles of professional conduct:
• Question 3
0 out of 4 points
How many components are included in an effective compliance plan?
Selected c. Answer: 9
Correct d.
Answer: 7
Response Rationale: The following list of components, as set forth in previous OIG
Feedback: Compliance Program Guidance for Individual and Small Group Physician Practices, can
form the basis of a voluntary compliance program for a provider practice:
• Conducting internal monitoring and auditing through the performance
of periodic audits;
• Implementing compliance and practice standards through the
development of written standards and procedures;
• Designating a compliance officer or contact(s) to monitor compliance
efforts and enforce practice standards;
• Conducting appropriate training and education on practice standards
and procedures;
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