Chapter 1 Exam
Region
LCDs only have jurisdiction in their ____.
Each regional MAC
Local Coverage Determinations are administered by whom?
Timely submission of claims
Which of the following is a BENEFIT of electronic transactions?
Patients
A covered entity does NOT include
Research
A covered entity may obtain consent from an individual to use or disclose protected health information to carry out all of the following EXCEPT what?
Advance Beneficiary Notice
ABN stands for _____.
legal and ethical
According to AAPC's Code of Ethics, an AAPC member shall use only ____ and ____ means in all professional dealings.
Efficiency
According to the AAPC Code of Ethics, which term is NOT listed as an ethical principle of professional conduct?
Periodic audits.
According to the OIG, internal monitoring and auditing should be performed by what means?
Electronic health record
EHR stands for:
1988
In what year was the AAPC founded?
30
HITECH provides a ____ day window during which any violation not due to willful neglect may be corrected without penalty.
Notices of Privacy Practices
Healthcare providers are responsible for developing ____ ____ and policies and procedures regarding privacy in their practices.
Medicare Administrative Contractor (MAC)
If an NCD does not exist for a particular service/procedure performed on a Medicare patient, who determines coverage?
2009
In what year was HITECH enacted as part of the American Recovery and Reinvestment Act?
Consultants
Many coding professionals go on to find work as:
Coding specialists
Professionals who specialize in coding are called:
Continuing education and networking
The AAPC offers over 500 local chapters across the country for the purpose of
Part B
The Medicare program is made up of several parts. Which part covers provider fees without the use of a private insurer?
Consistent and appropriate
The OIG recommends that provider practices enforce disciplinary actions through well publicized compliance guidelines to ensure actions that are ______.
Work Plan
The OIG releases a ____ outlining its priorities for the fiscal year ahead and beyond.
National Coverage Determinations Manual
The ____describes whether specific medical items, services, treatment procedures or technologies are considered medically necessary under Medicare.
Covered entities taking reasonable steps to limit use or disclosure of PHI
The minimum necessary rule applies to
Providers should develop safeguards to prevent unauthorized access to protected health information.
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?
Fraudulent claims
Voluntary compliance programs also provide benefits by not only helping to prevent erroneous or ____, but also by showing that the provider practice is making additional good faith efforts to submit claims appropriately.
CMS-1500
What form is used to submit a provider's charge to the insurance carrier?
Protected health information
What is PHI?
Translating documentation into numerical/alphanumerical codes used to obtain reimbursement.
What is the definition of medical coding?
It states what will be paid and why any changes to charges were made.
What is the value of a remittance advice?
Medicaid
What type of health insurance provides coverage for low-income families?
Prescription drug coverage available to all Medicare beneficiaries.
What type of insurance is Medicare Part D?
Physician Assistant (PA)
What type of provider goes through approximately 26 ½ months of education and is licensed to practice medicine with the oversight of a physician?
The size and resources of the provider's practice.
What will the scope of a compliance program depend on?
CPT®, HCPCS Level II and ICD-10-CM
Which coding manuals do outpatient coders focus on learning?
Eliminates risk of an audit.
Which of the following choices is NOT a benefit of an active compliance plan?
Financial records
Which type of information is NOT maintained in a medical record?
