Physician Coding for CPC Preparation (Q-S) | All Exams Questions and Answers All Answers

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Question 1 10 out of 10 points What document is referenced to when looking for potential problem areas identified by the government indicating scrutiny of the services within the coming year? Sele... cted Answer: c. OIG Work Plan Correct Answer: c. OIG Work Plan Response Feedback: 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.  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 Answer: d. muscle weakness Correct Answer: b. fibromyalgia Response Feedback: Rationale: According to the LCD, measurement of vitamin D levels is indicated for patients with fibromyalgia.  Question 3 10 out of 10 points Under HIPAA, what would be a policy requirement for “minimum necessary”? Selected Answer: a. Only individuals whose job requires it may have access to protected health information. Correct Answer: a. Only individuals whose job requires it may have access to protected health information. Response Feedback: 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.  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 Answer: a. HIPAA Correct Answer: b. HITECH Response Feedback: 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.  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 Answer: d. ABN Correct Answer: d. ABN Response Feedback: 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.  Question 6 0 out of 10 points What document assists provider offices with the development of Compliance Manuals? Selected Answer: c. OIG Suggested Rules and Regulations Correct Answer: a. OIG Compliance Plan Guidance Response Feedback: 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.  Question 7 10 out of 10 points Who would NOT be considered a covered entity under HIPAA? Selected d. Answer: Patients Correct Answer: d. Patients Response Feedback: Rationale: Covered entities in relation to HIPAA include Health Care 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 Answer: a. ABNs may not be recognized by non-Medicare payers. Correct Answer: a. ABNs may not be recognized by non-Medicare payers. Response Feedback: 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.  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 Answer: c. $100 or 25 percent Correct Answer: c. $100 or 25 percent Response Feedback: 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.”  Question 10 10 out of 10 points Which statement describes a medically necessary service? Selected Answer: b. Using the least radical service/procedure that allows for effective treatment of the patient’s complaint or condition. Correct Answer: b. Using the least radical service/procedure that allows for effective treatment of the patient’s complaint or condition. Response Feedback: Rationale: Medical necessity is using the least radical services/procedure 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 User Course 2017 Physician Coding for CPC Preparation (Q-S) Test Chapter 1 Quiz Started 6/9/17 9:09 PM Submitted 6/9/17 9:30 PM Status Completed Attempt Score 100 out of 100 points Time Elapsed 21 minutes Results Displayed Submitted Answers, Correct Answers, Feedback  Question 1 10 out of 10 points Select the TRUE statement regarding ABNs. Selected Answer: a. ABNs may not be recognized by non-Medicare payers. Correct Answer: a. ABNs may not be recognized by non-Medicare payers. Response Feedback: 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.  Question 2 10 out of 10 points Under HIPAA, what would be a policy requirement for “minimum necessary”? Selected Answer: a. Only individuals whose job requires it may have access to protected health information. Correct Answer: a. Only individuals whose job requires it may have access to protected health information. Response Feedback: 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.  Question 3 10 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 Answer: b. fibromyalgi a Correct Answer: b. fibromyalgi a Response Feedback: Rationale: According to the LCD, measurement of vitamin D levels is indicated for patients with fibromyalgia.  Question 4 10 out of 10 points What document assists provider offices with the development of Compliance Manuals? Selected Answer: a. OIG Compliance Plan Guidance Correct Answer: a. OIG Compliance Plan Guidance Response Feedback: 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.  Question 5 10 out of 10 points Who would NOT be considered a covered entity under HIPAA? Selected Answer: d. Patients Correct Answer: d. Patients Response Feedback: Rationale: Covered entities in relation to HIPAA include Health Care 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 6 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 Answer: d. ABN Correct Answer: d. ABN Response Feedback: 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.  Question 7 10 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 Answer: b. HITECH Correct Answer: b. HITECH Response Feedback: 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.  Question 8 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 Answer: c. $100 or 25 percent Correct Answer: c. $100 or 25 percent Response Feedback: 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.”  Question 9 10 out of 10 points Which statement describes a medically necessary service? Selected Answer: b. Using the least radical service/procedure that allows for effective treatment of the patient’s complaint or condition. Correct Answer: b. Using the least radical service/procedure that allows for effective treatment of the patient’s complaint or condition. Response Feedback: Rationale: Medical necessity is using the least radical services/procedure that allows for effective treatment of the patient’s complaint or condition.  Question 10 10 out of 10 points 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 Answer: c. OIG Work Plan Correct Answer: c. OIG Work Plan Response Feedback: 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. Thursday, September 21, 2017 7:47:41 PM MDT Review Test Submission: 2017 Chapter 1 Practical Application User Course 2017 Physician Coding for CPC Preparation (Q-S) Test 2017 Chapter 1 Practical Application Started 6/10/17 12:52 PM Submitted 6/10/17 12:58 PM Status Completed Attempt Score 90 out of 100 points Time Elapsed 5 minutes Results Displayed Submitted Answers, Correct Answers, Feedback  Question 1 10 out of 10 points What type of profession, other than coding, might skilled coders enter? Selected Answer: c. Consultants, educators, medical auditors Correct Answer: c. Consultants, educators, medical auditors  Question 2 10 out of 10 points What is the difference between outpatient and inpatient coding? Selected Answer: d. Inpatient coders use ICD-10-CM and ICD-10-PCS. Correct Answer: d. Inpatient coders use ICD-10-CM and ICD-10-PCS.  Question 3 10 out of 10 points What is a mid-level provider? Selected Answer: c. Mid-level providers include physician assistants (PA) and nurse practitioners (NP). Correct Answer: c. Mid-level providers include physician assistants (PA) and nurse practitioners (NP).  Question 4 10 out of 10 points What are the different parts of Medicare? Selected Answer: b. Part A, B, C, D Correct Answer: b. Part A, B, C, D  Question 5 10 out of 10 points Evaluation and management (E/M) services are often provided and documented in a standard format. One such format is SOAP notes. What does SOAP represent? Selected Answer: a. Subjective, Objective, Assessment, Plan Correct Answer: a. Subjective, Objective, Assessment, Plan  Question 6 10 out of 10 points What are five tips for coding operative (op) reports? Selected Answer: b. Diagnosis code reporting, Start with the procedures listed, Look for key words, Highlight unfamiliar words, Read the body Correct Answer: b. Diagnosis code reporting, Start with the procedures listed, Look for key words, Highlight unfamiliar words, Read the body  Question 7 10 out of 10 points What is medical necessity? Selected Answer: d. Relates to whether a procedure or service is considered appropriate in a given circumstance. Correct Answer: d. Relates to whether a procedure or service is considered appropriate in a given circumstance.  Question 8 0 out of 10 points What is not a common reason Medicare may deny a procedure or service? Selected Answer: a. Patient's condition Correct Answer: c. Covered service Response Feedback: Medicare doesn't pay for the procedure/service to treat the patient's condition Medicare doesn't pay for the procedure/service as frequently as proposed Medicare doesn't pay for experimental procedures/services  Question 9 10 out of 10 points Under the Privacy Rule, the minimum necessary standard does NOT apply to to what type of disclosures? Selected Answer: c. Disclosures to the individual who is the subject of the information. Correct Answer: c. Disclosures to the individual who is the subject of the information.  Question 10 10 out of 10 points Which is not one of the seven key components of an internal compliance plan? Selected Answer: b. Conduct training but not perform education on practice standards and procedures. Correct Answer: b. Conduct training but not perform education on practice standards and procedures. Thursday, September 21, 2017 7:48:29 PM MDT Review Test Submission: Chapter 1 Review User Course 2017 Physician Coding for CPC Preparation (Q-S) Test Chapter 1 Review Started 6/10/17 1:01 PM Submitted 6/10/17 1:24 PM Status Completed Attempt Score 100 out of 100 points Time Elapsed 22 minutes out of 2 hours Results Displayed Submitted Answers, Correct Answers, Feedback  Question 1 4 out of 4 points When are providers responsible for obtaining an ABN for a service NOT considered medically necessary? Selected Answer: a. Prior to providing a service or item to a beneficiary. Correct Answer: a. Prior to providing a service or item to a beneficiary. Response Feedback: Rationale: Providers are responsible for obtaining an ABN prior to providing the service or item to a beneficiary.  Question 2 4 out of 4 points HIPAA stands for Selected Answer: c. Health Insurance Portability and Accountability Act Correct Answer: c. Health Insurance Portability and Accountability Act Response Feedback: Rationale: Health Insurance Portability and Accountability Act (HIPAA)  Question 3 4 out of 4 points The ____describes whether specific medical items, services, treatment procedures or technologies are considered medically necessary under Medicare. Selected Answer: d. National Coverage Determinations Manual Correct Answer: d. National Coverage Determinations Manual Response Feedback: Rationale: The National Coverage Determinations Manual describes whether specific medical items, services, treatment procedures or technologies are considered medically necessary under Medicare.  Question 4 4 out of 4 points According to AAPC’s Code of Ethics, an AAPC member shall use only ____ and ____ means in all professional dealings. Selected Answer: b. legal and ethical Correct Answer: b. legal and ethical Response Feedback: Rationale: AAPC members shall use only legal and ethical means in all professional dealings and shall refuse to cooperate with, or condone by silence, the actions of those who engage in fraudulent, deceptive or illegal acts.  Question 5 4 out of 4 points Which provider is NOT a mid-level provider? Selected Answer: d. Anesthesiologis t Correct Answer: d. Anesthesiologis t Response Feedback: Rationale: Mid-level providers include physician assistants (PA) and nurse practitioners (NP). An anesthesiologist is a physician. Mid-level providers are also known as physician extenders because they extend the work of a physician.  Question 6 4 out of 4 points What is the definition of medical coding? Selected Answer: d. Translating documentation into numerical/alphanumerical codes used to obtain reimbursement. Correct Answer: d. Translating documentation into numerical/alphanumerical codes used to obtain reimbursement. Response Feedback: Rationale: Medical coding is the process of translating a healthcare provider's documentation of a patient encounter into a series of numeric or alphanumeric codes.  Question 7 4 out of 4 points In what year was the AAPC founded? Selected Answer: a. 1988 Correct Answer: a. 1988 Response Feedback: Rationale: The AAPC was founded in 1988.  Question 8 4 out of 4 points What is the purpose of National Coverage Determinations? Selected Answer: d. To explain CMS policies on when Medicare will pay for items or services. Correct Answer: d. To explain CMS policies on when Medicare will pay for items or services. Response Feedback: Rationale: National Coverage Determinations (NCD) explain CMS policies on when Medicare will pay for items or services.  Question 9 4 out of 4 points HITECH provides a ____ day window during which any violation not due to willful neglect may be corrected without penalty. Selected Answer: c. 30 Correct Answer: c. 30 Response Feedback: Rationale: HITECH also lowers the bar for what constitutes a violation, but provides a 30-day window during which any violation not due to willful neglect may be corrected without penalty.  Question 10 4 out of 4 points How many components are included in an effective compliance plan? Selected Answer: b. 7 Correct Answer: b. 7 Response Feedback: Rationale: The following list of components, as set forth in previous OIG Compliance Program Guidance for Individual and Small Group Physician Practices, can form the basis of a voluntary compliance program for a provider practice: • Conducting internal monitoring and auditing through the performance of periodic audits; • Implementing compliance and practice standards through the development of written standards and procedures; • Designating a compliance officer or contact(s) to monitor compliance efforts and enforce practice standards; • Conducting appropriate training and education on practice standards and procedures; • Responding appropriately to detected violations through the investigation of allegations and the disclosure of incidents to appropriate Government entities; • Developing open lines of communication, such as (1) discussions at staff meetings regarding how to avoid erroneous or fraudulent conduct, and (2) community bulletin boards, to keep practice employees updated regarding compliance activities; and • Enforcing disciplinary standards through well-publicized guidelines. These seven components provide a solid basis upon which a provider practice can create a compliance program.  Question 11 4 out of 4 points Who is responsible for enforcing the HIPAA security rule? Selected Answer: c. OCR Correct Answer: c. OCR Response Feedback: Rationale: The Office for Civil Rights (OCR) enforces the HIPAA Privacy Rule.  Question 12 4 out of 4 points In what year did HIPAA become law? Selected Answer: b. 1996 Correct Answer: b. 1996 Response Feedback: Rationale: HIPAA was adopted into law in 1996.  Question 13 4 out of 4 points The Medicare program is made up of several parts. Which part covers provider fees without the use of a private insurer? Selected Answer: c. Part B Correct Answer: c. Part B Response Feedback: Rationale: Medicare Part B helps to cover medically necessary provider services, outpatient care and other medical services (including some preventive services) not covered under Medicare Part A. Medicare Part B is an optional benefit for which the patient pays a monthly premium, an annual deductible, and generally has a 20% co-insurance except for preventive services covered under the healthcare law.  Question 14 4 out of 4 points Which option below is NOT a covered entity under HIPAA? Selected Answer: b. Workers’ Compensation Correct Answer: b. Workers’ Compensation Response Feedback: Rationale: The definition of health plan in the HIPAA regulations excludes any policy, plan or program that provides or pays for the cost of excepted benefits. Excepted benefits include: • Coverage only for accident or disability income insurance, or any combination thereof; • Coverage issued as a supplement to liability insurance; • Liability insurance, including general liability insurance and automobile liability insurance; • Workers’ compensation or similar insurance; • Automobile medical payment insurance; • Credit-only insurance; • Coverage for on-site medical clinics; • Other similar insurance coverage, specified in regulations, under which benefits for medical care are secondary or incidental to other insurance benefits.  Question 15 4 out of 4 points Healthcare providers are responsible for developing ____ ____ and policies and procedures regarding privacy in their practices. Selected Answer: a. Notices of Privacy Practices Correct Answer: a. Notices of Privacy Practices Response Rationale: Healthcare providers are responsible for developing Notices of Feedback: Privacy Practices and policies and procedures regarding privacy in their practices.  Question 16 4 out of 4 points What type of provider goes through approximately 26 ½ months of education and is licensed to practice medicine with the oversight of a physician? Selected Answer: d. Physician Assistant (PA) Correct Answer: d. Physician Assistant (PA) Response Feedback: Rationale: Physician Assistants are licensed to practice medicine with physician supervision. A PA program takes approximately 26 ½ months to complete.  Question 17 4 out of 4 points AAPC credentialed coders have proven mastery of what information? Selected Answer: d. All of the above Correct Answer: d. All of the above Response Feedback: Rationale: AAPC credentialed coders have proven mastery of all code sets, evaluation and management principles, and documentation guidelines.  Question 18 4 out of 4 points What will the scope of a compliance program depend on? Selected Answer: b. The size and resources of the provider’s practice. Correct Answer: b. The size and resources of the provider’s practice. Response Feedback: Rationale: The scope of a compliance program will depend on the size and resources of the provider practice.  Question 19 4 out of 4 points What does MAC stands for? Selected Answer: b. Medicare Administrative Contractor Correct Answer: b. Medicare Administrative Contractor Response Feedback: Rationale: Medicare Administrative Contractor (MAC)  Question 20 4 out of 4 points The minimum necessary rule applies to Selected Answer: c. Covered entities taking reasonable steps to limit use or disclosure of PHI Correct Answer: c. Covered entities taking reasonable steps to limit use or disclosure of PHI Response Feedback: Rationale: The Privacy Rule generally requires covered entities to take reasonable steps to limit the use or disclosure of, and requests for, protected health information to the minimum necessary to accomplish the intended purpose. The minimum necessary standard does not apply to the following: · Disclosures to or requests by a health care provider for treatment purposes. · Disclosures to the individual who is the subject of the information. · Uses or disclosures made pursuant to an individual’s authorization. · Uses or disclosures required for compliance with the Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Rules. · Disclosures to the Department of Health & Human Services (HHS) when disclosure of information is required under the Privacy Rule for enforcement purposes. · Uses or disclosures that are required by other law.  Question 21 4 out of 4 points Many coding professionals go on to find work as: Selected Answer: b. Consultant s Correct Answer: b. Consultant s Response Feedback: Rationale: The coding profession has evolved significantly over the past several decades into a career path with unlimited possibilities. Many professionals who have learned coding have also gone on to roles as consultants, educators or medical auditors. There are endless possibilities in an ever changing field.  Question 22 4 out of 4 points A covered entity does NOT include Selected Answer: c. Patients Correct Answer: c. Patients Respo nse Rationale: Feedb ack:  Question 23 4 out of 4 points The Medicare program is made up of several parts. Which part is affected by the Centers for Medicare & Medicaid Services - Hierarchical Condition Categories (CMS-HCC)? Selected Answer: d. Part C Correct Answer: d. Part C Response Feedback: Rationale: Accurate and thorough diagnosis coding is important for Medicare Advantage (Part C) claims because reimbursement is impacted by the patient’s health status. The Centers for Medicare & Medicaid Serviceshierarchical condition category (CMS-HCC) risk adjustment model provides adjusted payments based on a patient’s diseases and demographic factors. If a coder does not include all pertinent diagnoses and comorbidities, there may be loss of additional reimbursement to which the provider is entitled.  Question 24 4 out of 4 points In what year was HITECH enacted as part of the American Recovery and Reinvestment Act? Selected Answer: d. 2009 Correct Answer: d. 2009 Response Feedback: Rationale: The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009, to promote the adoption and meaningful use of health information technology.  Question 25 4 out of 4 points The OIG recommends that provider practices enforce disciplinary actions through well publicized compliance guidelines to ensure actions that are ______. Selected Answer: d. Consistent and appropriate Correct Answer: d. Consistent and appropriate Response Feedback: Rationale: The OIG recommends that a provider practice’s enforcement and disciplinary mechanisms ensure that violations of the practice’s compliance policies will result in consistent and appropriate sanctions, including the possibility of termination, against the offending individual. Thursday, September 21, 2017 7:48:49 PM MDT Review Test Submission: Chapter 2 Quiz User Course 2017 Physician Coding for CPC Preparation (Q-S) Test Chapter 2 Quiz Started 6/11/17 6:16 PM Submitted 6/11/17 6:21 PM Status Completed Attempt Score 80 out of 100 points Time Elapsed 5 minutes Results Displayed Submitted Answers, Correct Answers, Feedback  Question 1 10 out of 10 points Which medical term refers to the cheek? Selected Answer: a. Bucca l Correct Answer: a. Bucca l Response Feedback: RATIONALE: Bucca means cheek. Buccal is relating to the cheek. Buccal swabs can be used for DNA testing.  Question 2 10 out of 10 points What is the root meaning joint? Selected Answer: a. Arthr/o Correct Answer: a. Arthr/o Response Feedback: RATIONALE: The root Arthr/o stands for joint. You will notice in the list of medical terms related to the musculoskeletal system, all of the words beginning with “arthr” are conditions or procedures related to the joint.  Question 3 10 out of 10 points The heart circulates blood through the lungs and is sent back into the left atrium of the heart via which vessel(s)? Selected Answer: b. Left and right pulmonary veins Correct Answer: b. Left and right pulmonary veins Response Feedback: RATIONALE: Blood is circulated through the pulmonary vascular tree in the lungs and sent back into the left atrium through the left and right pulmonary veins.  Question 4 10 out of 10 points Which gland is larger in early life than [Show More]

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