Aapc

When coding in operative report what action would NOT be recommended? Coding from the header with out reading the body of the report If an NCD doesn't exist for a particular service/procedure performed on a Medicare patient who determines coverage? Medicare administrative contractor (MAC) MAC stands for what!? Medicare administrative contractor What is the definition of coding? Translating documentation into numerical/alphabetical codes used to obtain reimbursement. How many components sh...

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.) 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 D (...

What type of provider goes through approximately 26 1/2 months of education and is licensed to practice medicine with the oversight of a physician? Physician Assistant (PA) The ____ describes whether specific medical items, services, treatment procedures, or technologies are considered medically necessary under Medicare National Coverage Determinations LCD's only have jurisdiction in their ____ area. Regional ABN stands for Advance Beneficiary Notice HIPPA was made into law in what year? ...

"hold harmless clause" * 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: * 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 entity that processes nonstandard health information they receive from anothe...

What document assists provider offices with the development of Compliance Manuals? OIG Compliance Program Guidance What document is referenced to when looking for potential problem areas identified by the government indicating scrutiny of the services? OIG Work Plan Why do you give ABN form To warn Medicare may not cover Why was hitech enacted. To promote use of health info tech What is mips Merit based Incentive Payment System ties physicians Medicare payments to their individual group subm...

Local Coverage Determinations are administered by whom? a. State Law b. NCDs c. Each regional MAC d. LMRPs c. Each regional MAC ABN stands for _____. a. Advanced Benefits Notification b. Advisory Beneficial Notice c. Admitting Beneficiary Notice d. Advance Beneficiary Notice d. Advance Beneficiary Notice What type of health insurance provides coverage for low-income families? a. Commercial HMO b. Medicaid c. Medicare d. Commercial PPO b. Medicaid Which type of information is NOT maintained...

What anatomical or compartment contains all the thoracic viscera except the lungs? Mediastinum Who is responsible for enforcing the HIPAA security rule Office of Civil Rights (OCR) ABN Advance Beneficiary Notice According to the OIG, internal monitoring and auditing should be performed by what means? Periodic audits What does the abbreviation MAC stand for? Medicare Administrative Contractor How many lobes make up the RIGHT lung? the right has 3 lobes the left has 2 lobes Condition in whic...

Many coding professionals go on to find work as: Consultant A medical record contains information on all but what areas? Financial records Technicians who specialize in coding are called: Coding specialists EHR stands for: Electronic health record What type of provider goes through approximately 26.5 months of education and is licensed to practice medicine with the oversight of a physician? Physician Assistant (PA) The Medicare program is made up of several parts. Which part is most signifi...

A 46-year-old female had a previous biopsy that indicated positive malignant margins anteriorly on the right side of her neck. A 0.5 cm margin was drawn out and a 15 blade scalpel was used for full excision of an 8 cm lesion. Layered closure was performed after the removal. The specimen was sent for permanent histopathologic examination. What are the CPT® code(s) for this procedure? A. 11626 B. 11626, 12004-51 C. 11626, 12044-51 D. 11626, 13132-51, 13133 C. 11626, 12044-51 A 30-year-old female...

AAPC CPC FINAL REAL EXAM QUESTIONS WITH CORRECT ANSWERS 2023/2024 A 46-year-old female had a previous biopsy that indicated positive malignant margins anteriorly on the right side of her neck. A 0.5 cm margin was drawn out and a 15 blade scalpel was used for full excision of an 8 cm lesion. Layered closure was performed after the removal. The specimen was sent for permanent histopathologic examination. What are the CPT® code(s) for this procedure? 11626 11626, , , 13132-51, 13133 - C. 11626, 12...