AAPC Certified Professional Coder Exam Preparation, Exams of Advanced Education

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AAPC CERTIFIED PROFESSIONAL CODER

ACTUAL EXAM SOLVED QUESTIONS AND

ANSWERS 2023

Many coding professionals go on to find work as: - ANS Consultant A medical record contains information on all but what areas? - ANS Financial records Technicians who specialize in coding are called: - ANS Coding specialists EHR stands for: - ANS 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? - ANS Physician Assistant (PA) The Medicare program is made up of several parts. Which part is most significant to coders working in physician offices and covers physician fees without the use of a private insurer? - ANS Part B The Medicare program is made up of several parts. Which part is affected by the Centers for Medicare and Medicaid Services' - hierarchal condition categories (CMS-HCC)? - ANS Part C What does CMS-HCC stand for? - ANS Centers for Medicare and Medicaid Services - Hierarchal Condition Category When coding an operative report, what action would NOT be recommended? - ANS Coding from the header without reading the body of the report Outpatient coders focus on learning which coding manuals? - ANS CPT, HCPCS Level II, and ICD- 9 - CM Volumes 1 and 2 If an NCD doesn't exist for a particular service/procedure performed on a Medicare patient, who determines coverage? - ANS Medicare Administrative Contractor (MAC) The __ describes whether specific medical items, services, treatment procedures, or technologies are considered medically necessary under Medicare. - ANS National Coverage Determinations Manual National Coverage Determinations serve what purpose? - ANS To spell out CMS policies on when Medicare will pay for items or services

MAC stands for what? - ANS Medicare Administrative Contractor Local Coverage Determinations are administered by __? - ANS Each regional MAC LCD's only have jurisdiction in their __ area. - ANS Regional ABN stands for - ANS Advance Beneficiary Notice When are providers responsible for obtaining an ABN for a service not considered medically necessary? - ANS Prior to providing a service or item to a beneficiary HIPAA stands for - ANS Health Insurance Portability and Accountability Act HIPAA was made into law in what year? - ANS 1996 A covered entity does NOT include - ANS Patient What is the definition of coding? - ANS Translating documentation into numerical/alphanumerical codes used to obtain reimbursement Who is responsible for enforcing he HIPAA security rule? - ANS OCR Healthcare providers are responsible for developing __ and policies and procedures regarding privacy in their practices. - ANS Notices of Privacy Practices A covered entity may obtain consent of the individual to use or disclose protected health information to carry out all but what of the following? - ANS For public use The minimum necessary rule is based on sound current practice that protected health information should not be used or disclosed when it is not necessary to satisfy a particular purpose or carry out a function. What does this mean? - ANS Providers should develop safeguards to prevent unauthorized access The minimum necessary rule applies to: - ANS Covered entities taking responsible steps HITECH provides a ___ day window which any violation not due willful neglect may be corrected without penalty? - ANS 30 HITECH was enacted as part of the American Recovery and Reinvestment Act in what year? - ANS 2009 Which of the following choices is NOT a benefit of an active compliance plan? - ANS Eliminates risk of an audit

What will the scope of a compliance program depend on? - ANS Size and resources of the physician's practice HHS/OCR has investigated and resolved over __ cases by requiring changes in privacy practices and other corrective actions by the covered entities since its inception in 2003. - ANS 14, According to the OIG, internal monitoring and auditing should be performed by what means? - ANS Periodic audits Voluntary compliance programs also provide benefits by not only helping to prevent erroneous or ___, but also by showing that the physician practice is making additional good faith efforts to submit claims appropriately. - ANS Fraudulent claims How many components should be included in an effective compliance plan? - ANS 7 According to AAPC's Code of Ethics, a member shall use only __ and ___ means in all professional dealings. - ANS Legal and ethical Medicare Part D is what type of insurance? - ANS Prescription drug coverage available to all Medicare Beneficiaries What type of health insurance provides coverage for low-income families? - ANS Medicaid What is PHI? - ANS Protected health information What form is used to send a provider's charge to the insurance carrier? - ANS CMS- 1500 Which option below is NOT a covered entity under HIPAA? - ANS Worker's Compensation Which of the following is a BENEFIT of electronic transactions? - ANS Timely submission of claims What is the value of a remittance advice? - ANS It tells you what you will be paid and why ay changes to charges were made. The OIG recommends that the physician's practice enforcement and disciplinary mechanisms be - ANS Consistent Each October the OIC releases a __ outlining its priorities fo the fiscal year ahead - ANS Work Plan The 2012 OIG work Plan prioritizes which of the following topics for review? - ANS E/M services during the global surgery periods

The AAPC was founded in what year? - ANS 1988 According to the 2012 AAPC ___, which it shows coders salaries rose 2 percent to an average of $47, 870 for credential coders. - ANS Salary survey AAPC credentialed coders have NOT proven mastery of: - ANS Administrative regulations The AAPC offers over 440 local chapters across the country and in the Bahamas for the purpose of - ANS Networking