CPC final exam Prep Questions and Answers. Latest 2020.• Question 1
10 out of 10 points
What form is provided to a patient to indicate a service
... [Show More] 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 2
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 3
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 4
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 5
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.
fibromyalgia
Correct Answer: b.
fibromyalgia
Response Feedback: Rationale: According to the LCD, measurement of vitamin D levels is indicated for patients with fibromyalgia.
• Question 6
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 7
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 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 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 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. [Show Less]