AAPC chapter 1 exam

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 significant to coders working in physician offices and covers physician fees without the use of a private insurer?

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)?

Part C

What does CMS-HCC stand for?

Centers for Medicare and Medicaid Services - Hierarchal Condition Category

When coding an operative report, what action would NOT be recommended?

Coding from the header without reading the body of the report

Outpatient coders focus on learning which coding manuals?

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?

Medicare Administrative Contractor (MAC)

The __ describes whether specific medical items, services, treatment procedures, or technologies are considered medically necessary under Medicare.

National Coverage Determinations Manual

National Coverage Determinations serve what purpose?

To spell out CMS policies on when Medicare will pay for items or services

MAC stands for what?

Medicare Administrative Contractor

Local Coverage Determinations are administered by __?

Each regional MAC

LCD's only have jurisdiction in their __ area.

Regional

ABN stands for

Advance Beneficiary Notice

When are providers responsible for obtaining an ABN for a service not considered medically necessary?

Prior to providing a service or item to a beneficiary

HIPAA stands for

Health Insurance Portability and Accountability Act

HIPAA was made into law in what year?

1996

A covered entity does NOT include

Patient

What is the definition of coding?

Translating documentation into numerical/alphanumerical codes used to obtain reimbursement

Who is responsible for enforcing he HIPAA security rule?

OCR

Healthcare providers are responsible for developing __ and policies and procedures regarding privacy in their practices.

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?

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?

Providers should develop safeguards to prevent unauthorized access

The minimum necessary rule applies to:

Covered entities taking responsible steps

HITECH provides a ___ day window which any violation not due willful neglect may be corrected without penalty?

30

HITECH was enacted as part of the American Recovery and Reinvestment Act in what year?

2009

Which of the following choices is NOT a benefit of an active compliance plan?

Eliminates risk of an audit

What will the scope of a compliance program depend on?

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.

14,309

According to the OIG, internal monitoring and auditing should be performed by what means?

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.

Fraudulent claims

How many components should be included in an effective compliance plan?

7

According to AAPC's Code of Ethics, a member shall use only __ and ___ means in all professional dealings.

Legal and ethical

Medicare Part D is what type of insurance?

Prescription drug coverage available to all Medicare Beneficiaries

What type of health insurance provides coverage for low-income families?

Medicaid

What is PHI?

Protected health information

What form is used to send a provider's charge to the insurance carrier?

CMS-1500

Which option below is NOT a covered entity under HIPAA?

Worker's Compensation

Which of the following is a BENEFIT of electronic transactions?

Timely submission of claims

What is the value of a remittance advice?

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

Consistent

Each October the OIC releases a __ outlining its priorities fo the fiscal year ahead

Work Plan

The 2012 OIG work Plan prioritizes which of the following topics for review?

E/M services during the global surgery periods

The AAPC was founded in what year?

1988

According to the 2012 AAPC ___, which it shows coders salaries rose 2 percent to an average of $47, 870 for credential coders.

Salary survey

AAPC credentialed coders have NOT proven mastery of:

Administrative regulations

The AAPC offers over 440 local chapters across the country and in the Bahamas for the purpose of

Networking