AAPC CPC exam prep Compliance and Regulatory

AAPC CPC exam prep Compliance and

Regulatory


1. What document is referenced to when looking for potential

problem areas identified by the government indicating scrutiny

of the services within the coming year?

A) OIG Compliance Plan Guidance

B) OIG Security Summary

C) OIG Work Plan

D) OIG Investigation Plan - ANS -C (Rationale: Twice a year, the

OIG releases a Work Plan outlining its priorities for the fiscal

year ahead. Within the Work Plan, potential problem areas

with claims submissions are listed and will be targeted with

special scrutiny.)

,2. 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?

A) LCD

B) CMS-1500

C) UB-04

D) ABN - ANS -D (Rationale: An Advanced Beneficiary Notice

(ABN) is used when a Medicare 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.)




3. Under HIPAA, what would be a policy requirement for

"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 protected

health information.

C) Only the treating provider has access to protected health

information.

D) Anyone within the provider's office can have access to

protected health information. - ANS -A (Rationale: It is the

responsibility of a covered entity to develop and implement

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.)




4. Which statement describes a medically necessary service? :

A) Performing a procedure/service based on cost to eliminate

wasteful services.