Medical Coding Training: CPC exam {124 QUESTIONS AND ANSWERS}
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Medical Coding Training: CPC
Institution
Medical Coding Training: CPC
Medical Coding Training: CPC exam {124
QUESTIONS AND ANSWERS}
Which statement below describes a medically necessary service?
A. Performing a procedure/service based on cost to eliminate wasteful services.
B. Using the least radical service/procedure that allows for effective treatment of
the...
Medical Coding Training: CPC exam {124
QUESTIONS AND ANSWERS}
Which statement below describes a medically necessary service?
A. Performing a procedure/service based on cost to eliminate wasteful services.
B. Using the least radical service/procedure that allows for effective treatment of
the patient's complaint or condition.
C. Using the closest facility to perform a service or procedure.
D. Using the appropriate course of treatment to fit within the patient's lifestyle. -
CORRECT ANSWER B. Using the least radical service/procedure that allows for
effective treatment of the patient's complaint or condition.
Rationale: Medical necessity is using the least radical services/procedure that
allows for effective treatment of the patient's complaint or condition.
According to the example LCD from Novitas Solutions, measurement of vitamin D
levels is indicated for patients with condition?
A. fatigue
B. fibromyalgia
C. hypertension
D. muscle weakness - CORRECT ANSWER C. hypertension
Rationale: According to the LCD, measurement of vitamin D levels is indicated for
patients with fibromyalgia.
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 - CORRECT ANSWER D. ABN
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.
Select the true statement regarding ABNs.
A. ABNs may not be recognized by non-Medicare payers.
B. ABNs must be signed for emergency or urgent care.
C. ABNs are not required to include an estimate cost for the service.
D. ABNs should be routinely signed by Medicare beneficiaries in case Medicare
does not cover a service. - CORRECT ANSWER A. ABNs may not be
recognized by non-Medicare payers.
Rationale: ABNs may not be recognized by non-Medicare payers. Providers should
review their contracts to determine which payers will accept an ABN for services
not covered.
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?
A. $25 or 10%
B. $100 or 10%
C. $100 or 25%
D. An exact amount. - CORRECT ANSWER C. $100 or 25%
"Notifiers must make a good faith effort to insert a reasonable estimate...the
estimate should be within $100 or 25 percent of the actual costs, whichever is
greater."
Rationale: CMS instructions stipulate, "Notifiers must make a good faith effort to
insert a reasonable estimate...the estimate should be within $100 or 25 percent
of the actual costs, whichever is greater."
Who would NOT be considered a covered entity under HIPAA?
A. Doctors
B. HMOs
C. Clearinghouse
D. Patient - CORRECT ANSWER D. Patient
Rationale: Covered entities in relation to HIPAA include healthcare providers,
health plans, and healthcare clearinghouses. The patient is not considered a
covered entity although it is the patient's data that is protected.
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 protected health information.
C. Only the treatment physician has access to protected health information.
D. Anyone within the provider's office can have access to protected health
information. - CORRECT ANSWER A. Only individuals whose job requires it
may have access to protected health information.
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.
Which Act was enacted as part of the American Recovery and Reinvestment Act
of 2009 (ARRA) and affected privacy and security?
A. HIPAA
B. HITECH
C. SSA
D. FECA - CORRECT ANSWER B. HITECH
Rationale: The Health Information Technology for Economic and Clinical 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.
What document has been created to assist physician offices with the
development of compliance manuals?
A. OIG Compliance Plan Guidance
B. OIG Work Plan
C. OIG Suggested Rules and Regulations
D. OIG Internal Compliance Plan - CORRECT ANSWER A. OIG Compliance
Plan Guidance
Rationale: The OIG has offered compliance program guidance to form the basis of
a voluntary compliance program for physician offices. Although this was released
in October 2000, it is still active compliance guidance today.
What document should be referred 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 Work Plan
C. OIG Security Summary
D. OIG Document Planner - CORRECT ANSWER B. OIG Work Plan
Rationale: Each October, 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.
____ is a term standing for enlargement of the heart. - CORRECT ANSWER A.
Cardiomegaly
Response Feedback: Rationale: Cardio = heart, megaly = enlargement
A patient suffering from an abdominal aortic aneurysm involving a renal artery
undergoes endovascular repair deploying a fenestrated visceral autograft using
two visceral artery endoprostheses. Radiological supervision and interpretation
was performed. Select the CPT® code(s) for this procedure. - CORRECT
ANSWER D. 34842
Rationale: Look in the CPT® Index for Repair/Aorta/Visceral/Endovascular
directing you to code 34841-34848. Code 34842 is correct to report because two
visceral artery endoprostheses were used.
What is the term for the divider between the heart chamber walls? - CORRECT
ANSWER D. Septum
Rationale: The heart is divided into right and left sides by a septum, which is a
muscular wall.
How many layers of tissue does an artery have?
A. Three
B. Two
C. Four
D. One - CORRECT ANSWER A. Three
Rationale: An artery has three layers: an outer layer of tissue, a muscular middle,
and an inner layer of epithelial cells.
Chapter 1 the business of medicine - CORRECT ANSWER Coding as a
profession.
Medical coding - CORRECT ANSWER The process of translating a healthcare
providers documentation of a patient's encounter into a series of numeric or
alpha numeric codes. These code sets serve as a universal shorthand language to
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