ch 1 Flashcards

1
Q

In what year was the AAPC founded?

A

1988

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2
Q

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

A

medicaid

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3
Q

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

A

Eliminates risk of an audit.

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4
Q

What will the scope of a compliance program depend on?

A

The size and resources of the provider’s practice

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5
Q

What is the value of a remittance advice?

A

It states what will be paid and why any changes to charges were made

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6
Q

What does the abbreviation MAC stand for?

A

Medicare Administrative Contractor

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7
Q

According to the AAPC Code of Ethics, which term is NOT listed as an ethical principle of professional conduct?

A

Efficiency

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8
Q

If an NCD does not exist for a particular service/procedure performed on a Medicare patient, who determines coverage?

A

Medicare Administrative Contractor (MAC)

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9
Q

What is the purpose of National Coverage Determinations?

A

To explain CMS policies on when Medicare will pay for items or services.

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10
Q

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

A

Notices of Privacy Practices

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11
Q

Which coding manuals do outpatient coders focus on learning?

A

CPT®, HCPCS Level II and ICD-10-CM

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12
Q

Who is responsible for enforcing the HIPAA security rule?

A

The Office for Civil Rights (OCR)

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13
Q

The Medicare program is made up of several parts. Which part covers provider fees without the use of a private insurer?

A

part b

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14
Q

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

A

2009

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15
Q

The OIG releases a ____ outlining its priorities for the fiscal year ahead and beyond.

A

work plan

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16
Q

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)?

A

part c

17
Q

Which provider is NOT a mid-level provider?

A

Anesthesiologist

18
Q

HITECH provides a ____ day window during which any violation not due to willful neglect may be corrected without penalty.

A

30

19
Q

What is PHI?

A

Protected health information

20
Q

which of the following is a BENEFIT of electronic transactions?

A

Timely submission of claims

21
Q

According to AAPC’s Code of Ethics, an AAPC member shall use only ____ and ____ means in all professional dealings.

A

legal and ethical

22
Q

What form is used to submit a provider’s charge to the insurance carrier?

A

CMS-1500

23
Q

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?

A

Providers should develop safeguards to prevent unauthorized access to protected health information