AAPC CPC FINAL EXAM 100

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AAPC CPC FINAL EXAM 100

QUESTIONS AND CORRECT

ANSWERS( ANSWERS)

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

Options:

• UB-04
• Provider reimbursement form
• CMS-1500
• ABN

Correct answer: c. CMS-1500

Rationale: The CMS-1500 form is used by individual healthcare

providers to submit claims to insurance carriers for outpatient services, while UB-04 is typically used for institutional claims (e.g., hospitals).

Which coding manuals do outpatient coders focus on learning?

Options:

• CPT, HCPCS Level II and ICD-10-CM
• CPT and ICD-10-CM
• ICD-10-CM and ICD-10-PCS

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• CPT, HCPCS Level II, ICD-10-CM, ICD-10-PCS

Correct answer: a. CPT, HCPCS Level II and ICD-10-CM

Rationale: Outpatient coders use CPT for procedures, HCPCS

Level II for supplies and services, and ICD-10-CM for diagnoses. ICD-10-PCS is primarily for inpatient hospital procedures.

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

Options:

• 2010
• 2009
• 2000
• 2007

Correct answer: b. 2009

Rationale: The Health Information Technology for Economic

and Clinical Health (HITECH) Act was enacted on February 17, 2009, as part of the American Recovery and Reinvestment Act.

Voluntary compliance programs also provide benefits by not only helping to prevent erroneous or ____, but also by showing

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that the provider practice is making additional good faith efforts to submit claims appropriately.

Options:

• Over utilized codes
• Duplicative claims
• Fraudulent claims
• Mistaken principals

Correct answer: c. Fraudulent claims

Rationale: Compliance programs aim to prevent fraudulent

claims (intentional misrepresentation) and demonstrate good faith in billing practices.

Which CMS product describes whether specific medical items, services, treatment procedures or technologies are considered medically necessary under Medicare?

Options:

• Medicare Claims Processing Manual
• National Coverage Determinations Manual
• Relative Value Files
• Medicare Physician Fee Schedule Final Rule

Correct answer: b. National Coverage Determinations Manual

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Rationale: The National Coverage Determinations (NCD)

Manual outlines Medicare’s decisions on medical necessity for specific services and procedures.

Which condition results from an injury to the head? The symptoms include headache, dizziness and vomiting.

Options:

• Meningitis
• Concussion
• Epilepsy
• Parkinson's disease

Correct answer: b. Concussion

Rationale: A concussion, caused by a head injury, commonly

presents with symptoms such as headache, dizziness, and vomiting.

In order, starting with the innermost layer, what are the four walls of the digestive tract?

Options:

• Mucosa, submucosa, muscle, serosa
• Serosa, mucosa, submucosa, muscle