AAPC ICD10 Physician Coding for
CPC Preparation (All Exams) with
rationale
written by
gradebooster
www.stuvia.com
Downloaded by: gradebooster |
Distribution of this document is illegal
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
AAPC ICD10 Physician Coding for CPC Preparation (All Exams)
Review 10 out of 10 points
Test
Submissio
n: Chapter
1 Quiz
• Question 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?
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
Feedback: for the fiscal year ahead. Within the Work Plan, potential problem areas with
claims submissions are listed and will be targeted with special scrutiny.
• Question 2
0 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 d.
Answer: muscle
weakness
Correct b.
Answer: fibromyalgia
Response Rationale: According to the LCD, measurement of vitamin D levels is
Feedback: indicated for patients with fibromyalgia.
• Question 3
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.
Correct a.
Answer: Only individuals whose job requires it may have access to protected
health information.
Downloaded by: gradebooster |
Distribution of this document is illegal
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
AAPC ICD10 Physician Coding for CPC Preparation (All Exams)
Response Rationale: It is the responsibility of a covered entity to develop and
Feedback: 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.
• Question 4
0 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 a.
Answer: HIPAA
Correct b.
Answer: HITECH
Response Rationale: The Health Information Technology for Economic and Clinical
Feedback: Health 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 5
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 6
0 out of 10 points
What document assists provider offices with the development of Compliance Manuals?
Selected c.
Answer: OIG Suggested Rules and Regulations
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 7
10 out of 10 points
Who would NOT be considered a covered entity under HIPAA?
Selected d.
Downloaded by: gradebooster |
Distribution of this document is illegal
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
AAPC ICD10 Physician Coding for CPC Preparation (All Exams)
Answer: Patients
Correct d.
Answer: Patients
Response Rationale: Covered entities in relation to HIPAA include Health Care
Feedback: Providers, 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
Select the TRUE statement regarding ABNs.
Selected a.
Answer: ABNs may not be recognized by non-Medicare payers.
Correct a.
Answer: ABNs may not be recognized by non-Medicare payers.
Response Rationale: ABNs may not be recognized by non-Medicare payers. Providers
Feedback: should review their contracts to determine which payers will accept an ABN
for services not covered.
• Question 9
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
Feedback: effort to insert a reasonable estimate…the estimate should be within $100
or 25 percent of the actual costs, whichever is greater.”
• Question 10
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.
Correct b.
Answer: Using the least radical service/procedure that allows for effective treatment
of the patient’s complaint or condition.
Response Rationale: Medical necessity is using the least radical services/procedure
Feedback: that allows for effective treatment of the patient’s complaint or condition.
Thursday, September 21, 2017 7:47:13 PM MDT
Review Test Submission: Chapter 1 Quiz
Downloaded by: gradebooster |
Distribution of this document is illegal
CPC Preparation (All Exams) with
rationale
written by
gradebooster
www.stuvia.com
Downloaded by: gradebooster |
Distribution of this document is illegal
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
AAPC ICD10 Physician Coding for CPC Preparation (All Exams)
Review 10 out of 10 points
Test
Submissio
n: Chapter
1 Quiz
• Question 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?
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
Feedback: for the fiscal year ahead. Within the Work Plan, potential problem areas with
claims submissions are listed and will be targeted with special scrutiny.
• Question 2
0 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 d.
Answer: muscle
weakness
Correct b.
Answer: fibromyalgia
Response Rationale: According to the LCD, measurement of vitamin D levels is
Feedback: indicated for patients with fibromyalgia.
• Question 3
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.
Correct a.
Answer: Only individuals whose job requires it may have access to protected
health information.
Downloaded by: gradebooster |
Distribution of this document is illegal
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
AAPC ICD10 Physician Coding for CPC Preparation (All Exams)
Response Rationale: It is the responsibility of a covered entity to develop and
Feedback: 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.
• Question 4
0 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 a.
Answer: HIPAA
Correct b.
Answer: HITECH
Response Rationale: The Health Information Technology for Economic and Clinical
Feedback: Health 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 5
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 6
0 out of 10 points
What document assists provider offices with the development of Compliance Manuals?
Selected c.
Answer: OIG Suggested Rules and Regulations
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 7
10 out of 10 points
Who would NOT be considered a covered entity under HIPAA?
Selected d.
Downloaded by: gradebooster |
Distribution of this document is illegal
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
AAPC ICD10 Physician Coding for CPC Preparation (All Exams)
Answer: Patients
Correct d.
Answer: Patients
Response Rationale: Covered entities in relation to HIPAA include Health Care
Feedback: Providers, 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
Select the TRUE statement regarding ABNs.
Selected a.
Answer: ABNs may not be recognized by non-Medicare payers.
Correct a.
Answer: ABNs may not be recognized by non-Medicare payers.
Response Rationale: ABNs may not be recognized by non-Medicare payers. Providers
Feedback: should review their contracts to determine which payers will accept an ABN
for services not covered.
• Question 9
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
Feedback: effort to insert a reasonable estimate…the estimate should be within $100
or 25 percent of the actual costs, whichever is greater.”
• Question 10
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.
Correct b.
Answer: Using the least radical service/procedure that allows for effective treatment
of the patient’s complaint or condition.
Response Rationale: Medical necessity is using the least radical services/procedure
Feedback: that allows for effective treatment of the patient’s complaint or condition.
Thursday, September 21, 2017 7:47:13 PM MDT
Review Test Submission: Chapter 1 Quiz
Downloaded by: gradebooster |
Distribution of this document is illegal
