(Test Bank) Cpco 2021 Latest Review Medical Coding Training All Selected Corrected Answers Exam Pack

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Test Bank for Cpco 2021 Latest Review Medical Coding Training All Selected Corrected Answers Exam Pack, The downloadable file consists of 314 pages, and the total size of the file is 1.11 MB. Purchase now only for highly discounted price.

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Question 1 10 out of 10 points What form is provided to a patient to indicate a service 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. fibromyalgi a Correct Answer: b. fibromyalgi a 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 T echnology 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: T wice 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. Sunday, November 19, 2017 9:04:26 AM MST  The minimum necessary rule applies to Selected Answer: b. Disclosures to or requests by a health care provider for treatment purposes. Correct Answer: d. Covered entities taking reasonable steps to limit use or disclosure of PHI Response Feedback :Rationale: The Privacy Rule generally requires covered entities to take reasonable steps to limit the use or disclosure of, and requests for, protected health information to the minimum necessary to accomplish the intended purpose. The minimum necessary standard does not apply to the following: · Disclosures to or requests by a health care provider for treatment purposes. · Disclosures to the individual who is the subject of the information. · Uses or disclosures made pursuant to an individual’s authorization. · Uses or disclosures required for compliance with the Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Rules. · Disclosures to the Department of Health & Human Services (HHS) when disclosure of information is required under the Privacy Rule for enforcement purposes. · Uses or disclosures that are required by other law. Question 2 0 out of 4 points According to the AAPC Code of Ethics, which term is NOT listed as an ethical principle of professional conduct?Selected Answer: d. Commitmen t Correct Answer: b. Efficiency Response Feedback:Rationale: It shall be the responsibility of every AAPC member, as a condition of continued membership, to conduct themselves in all professional activities in a manner consistent with ALL of the following ethical principles of professional conduct: · · Integrity · Respect · Commitment · Competence · Fairness · Responsibility Question 3 0 out of 4 points How many components are included in an effective compliance plan? Selected Answer: c. 9 Correct Answer: d. 7 Response Feedback:Rationale: The following list of components, as set forth in previous OIG Compliance Program Guidance for Individual and Small Group Physician Practices, can form the basis of a voluntary compliance program for a provider practice: • Conducting internal monitoring and auditing through the performance of periodic audits; • Implementing compliance and practice standards through the development of written standards and procedures; • Designating a compliance officer or contact(s) to monitor compliance efforts and enforce practice standards; • Conducting appropriate training and education on practice standards and procedures; • Responding appropriately to detected violations through the investigation of allegations and the disclosure of incidents to appropriate Government entities; • Developing open lines of communication, such as (1) discussions at staff meetings regarding how to avoid erroneous or fraudulent conduct, and (2) community bulletin boards, to keep practice employees updated regarding compliance activities; and • Enforcing disciplinary standards through well-publicized guidelines. These seven components provide a solid basis upon which a provider practice can create a compliance program. Question 4 4 out of 4 points According to the OIG, internal monitoring and auditing should be performed by what means?Selected Answer: a. Periodic audits. Correct Answer: a. Periodic audits. Response Feedback :Rationale: A key component of an effective compliance program includes internal monitoring and auditing through the performance of periodic audits. This ongoing evaluation includes not only whether the provider practice’s standards and procedures are in fact current and accurate, but also whether the compliance program is working, (for example, whether individuals are properly carrying out their responsibilities and claims are submitted appropriately). Question 5 4 out of 4 points When coding an operative report, what action would NOT be recommended? Selected Answer: b. Coding from the header without reading the body of the report. Correct Answer: b. Coding from the header without reading the body of the report. Response Feedback:Rationale: Operative report coding tips include reviewing the documentation in the detail of the procedure to further clarify or define both procedures and diagnoses. Question 6 4 out of 4 points Which of the following choices is NOT a benefit of an active compliance plan? Selected Answer: a. Eliminates risk of an audit. Correct Answer: a. Eliminates risk of an audit. Response Feedback:Rationale: Although voluntary, a compliance plan may offer several benefits, among them: • Faster, more accurate payment of claims. • Fewer billing mistakes. • Diminished chances of a payer audit. • Less chance of violating self-referral and anti-kickback statutes. Additionally, the increased accuracy of provider documentation that may result from a compliance program actually may assist in enhancing patient care. Question 7 4 out of 4 points HIPAA stands for Selected Answer: d. Health Insurance Portability and Accountability Act Correct Answer: d. Health Insurance Portability and Accountability Act Response Feedback:Rationale: Health Insurance Portability and Accountability Act (HIPAA) Question 84 out of 4 points In what year was HITECH enacted as part of the American Recovery and Reinvestment Act? Selected Answer: a. 2009 Correct Answer: a. 2009 Response Feedback :Rationale: The Health Information T echnology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009, to promote the adoption and meaningful use of health information technology. Question 9 4 out of 4 points The Medicare program is made up of several parts. Which part covers provider fees without the use of a private insurer? Selected Answer: d. Part B Correct Answer: d. Part B Response Feedback :Rationale: Medicare Part B helps to cover medically necessary provider services, outpatient care and other medical services (including some preventive services) not covered under Medicare Part A. Medicare Part B is an optional benefit for which the patient pays a monthly premium, an annual deductible, and generally has a 20% co-insurance except for preventive services covered under the healthcare law. Question 10 4 out of 4 points Healthcare providers are responsible for developing ____ ____ and policies and procedures regarding privacy in their practices. Selected Answer: c. Notices of Privacy Practices Correct Answer: c. Notices of Privacy Practices Response Feedback:Rationale: Healthcare providers are responsible for developing Notices of Privacy Practices and policies and procedures regarding privacy in their practices. Question 11 4 out of 4 points Evaluation and management services are often provided in a standard format such as SOAP notes. What does the acronym SOAP stand for? Selected Answer: c. Subjective, Objective, Assessment, Plan Correct Answer: c. Subjective, Objective, Assessment, PlanResponse Feedback:Rationale: S-Subjective, O-Objective, A-Assessment, P-Plan Question 12 4 out of 4 points What type of health insurance provides coverage for low-income families? Selected Answer: b. Medicai d Correct Answer: b. Medicai d Response Feedback:Rationale: Medicaid is a health insurance assistance program for some low- income people (especially children and pregnant women) sponsored by federal and state governments. Question 13 0 out of 4 points The OIG recommends that provider practices enforce disciplinary actions through well publicized compliance guidelines to ensure actions that are ______. Selected Answer: a. Frequent Correct Answer: b. Consistent and appropriate Response Feedback:Rationale: The OIG recommends that a provider practice’s enforcement and disciplinary mechanisms ensure that violations of the practice’s compliance policies will result in consistent and appropriate sanctions, including the possibility of termination, against the offending individual. Question 14 4 out of 4 points What is the value of a remittance advice? Selected Answer: c. It states what will be paid and why any changes to charges were made. Correct Answer: c. It states what will be paid and why any changes to charges were made. Response Feedback:Rationale: The determination of the payer is sent to the provider in the form of a remittance advice. The remittance advice explains the outcome of the insurance adjudication on the claim, including the payment amount, contractual adjustments and reason(s) for denial. Question 15 4 out of 4 points HITECH provides a ____ day window during which any violation not due to willful neglect may be corrected without penalty. Selected Answer: c. 30 Correct Answer: c. 30Response Feedback:Rationale: HITECH also lowers the bar for what constitutes a violation, but provides a 30-day window during which any violation not due to willful neglect may be corrected without penalty. Question 16 4 out of 4 points AAPC credentialed coders have proven mastery of what information? Selected Answer: d. All of the above Correct Answer: d. All of the above Response Feedback:Rationale: AAPC credentialed coders have proven mastery of all code sets, evaluation and management principles, and documentation guidelines. Question 17 4 out of 4 points What form is used to submit a provider’s charge to the insurance carrier? Selected Answer: d. CMS-1500 Correct Answer: d. CMS-1500 Response Feedback:Rationale: Once documentation is translated into codes, it is then sent on a CMS-1500 form to the insurance carrier for reimbursement. Question 18 4 out of 4 points 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? Selected Answer: b. Providers should develop safeguards to prevent unauthorized access to protected health information. Correct Answer: b. Providers should develop safeguards to prevent unauthorized access to protected health information. Response Feedback :Rationale: The minimum necessary standard requires covered entities to evaluate their practices and enhance safeguards as needed to limit unnecessary or inappropriate access to and disclosure of protected health information. Only those individuals whose job requires it may have access to PHI. Only the minimum protected information required to do the job should be shared. Question 19 0 out of 4 points What is the purpose of National Coverage Determinations? Selected Answer: d. T o set standards for all payers on coverage items. Correct Answer: b. T o explain CMS policies on when Medicare will pay for items or services. Response Rationale: National Coverage Determinations (NCD) explain CMS policies on Feedback:when Medicare will pay for items or services. Question 20 4 out of 4 points T wice a year the OIG releases a ____ outlining its priorities for the fiscal year ahead. Selected Answer: b. Work Plan Correct Answer: b. Work Plan Response Feedback:Rationale: The OIG Work Plan sets forth various projects to be addressed twice during the fiscal year by the Office of Audit Services, Office of Evaluation and Inspections, Office of Investigations, and Office of Counsel to the Inspector General. Question 21 4 out of 4 points What will the scope of a compliance program depend on? Selected Answer: d. The size and resources of the provider’s practice. Correct Answer: d. The size and resources of the provider’s practice. Response Feedback:Rationale: The scope of a compliance program will depend on the size and resources of the provider practice. Question 22 4 out of 4 points Which coding manuals do outpatient coders focus on learning? Selected Answer: a. CPT®, HCPCS Level II and ICD-10-CM Correct Answer: a. CPT®, HCPCS Level II and ICD-10-CM Response Feedback:Rationale: Outpatient coding focuses on provider services. Outpatient coders will focus on learning CPT®, HCPCS Level II and ICD-10-CM. Question 23 4 out of 4 points What does CMS-HCC stand for? Selected Answer: c. Centers for Medicare & Medicaid Services – Hierarchal Condition Category Correct Answer: c. Centers for Medicare & Medicaid Services – Hierarchal Condition Category Response Feedback:Rationale: Centers for Medicare & Medicaid Services – Hierarchal Condition Category Question 24 0 out of 4 points Who is responsible for enforcing the HIPAA security rule? Selected Answer: d. HHSCorrect Answer: b. OCR Response Feedback:Rationale: The Office for Civil Rights (OCR) enforces the HIPAA Privacy Rule. Question 25 4 out of 4 points 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. Selected Answer: c. Fraudulent claims Correct Answer: c. Fraudulent claims Response Feedback:Rationale: Voluntary compliance programs also provide benefits by not only helping to prevent erroneous or fraudulent claims, but also by showing that the provider practice is making additional good faith efforts to submit claims appropriately. Sunday, November 19, 2017 9:05:23 AM MST Question 1 10 out of 10 points Squamous cell carcinoma and basal cell carcinoma are both cancers of cell tissue of the skin, lining of the blood vessels, respiratory, intestinal, urinary tracts, and other body systems. These carcinomas are found in what type of tissue? Selected Answer: d. Epithelial tissue Correct Answer: d. Epithelial tissue Response Feedback:RATIONALE: Squamous cell carcinoma and basal cell carcinoma are both cancers of cells in epithelial tissue. Epithelial tissues is found in the skin, lining of the blood vessels, respiratory, intestinal, and urinary tracts, and other body systems. Question 2 10 out of 10 points Which medical term refers to the cheek? Selected Answer: a. Bucca l Correct Answer: a. Bucca l Response Feedback:RATIONALE: Bucca means cheek. Buccal is relating to the cheek. Buccal swabs can be used for DNA testing. Question 310 out of 10 points Which layer is the middle layer of the eyeball? Selected Answer: b. Choroid Correct Answer: b. Choroid Response Feedback:RATIONALE: The eyeball has three layers: the retina (innermost), choroid (middle), and sclera (outermost). Question 4 10 out of 10 points Which anatomical structure in the urinary system differs in position and length between male and female, but serves the same function with regard to urine, and is often treated the same? Selected Answer: b. Urethra Correct Answer: b. Urethra Response Feedback:RATIONALE: The male and female urethras are quite different anatomically in position and length; however, they perform the same function with regard to urine, and are treated similarly for many surgical procedures in the coding genre. Question 5 10 out of 10 points Which structure of the ear is considered the inner ear? Selected Answer: b. Labyrint h Correct Answer: b. Labyrint h Response Feedback:RATIONALE: The ear has three distinct and separate anatomical divisions: the outer ear (external ear), middle ear (tympanic cavity), and inner ear (labyrinth). Question 6 10 out of 10 points Based on word parts, what is the definition of a tracheostomy? Selected Answer: b. Creation of a hole in the trachea. Correct Answer: b. Creation of a hole in the trachea. Response Feedback:RATIONALE: The root trache- means trachea. The suffix –ostomy means surgical creation of an opening. A tracheostomy is surgical creation of an opening in the trachea and is used to help a patient breathe. Question 7 0 out of 10 points Which structure is not a true endocrine structure?Selected Answer: c. Pituitary gland Correct Answer: b. Carotid body Response Feedback:RATIONALE: The carotid body is not a true endocrine structure, but is made of both glandular and nonglandular tissue. Question 8 10 out of 10 points Which layer of the epidermis is normally found on the palms of the hands and the soles of the feet? Selected Answer: b. Stratum Lucidum Correct Answer: b. Stratum Lucidum Response Feedback:RATIONALE: The stratum lucidum is a clear layer normally found only on the palms of the hands and the soles of the feet. Question 9 10 out of 10 points A cystourethroscopy is examination of what structures? Selected Answer: a. Bladder and urethra Correct Answer: a. Bladder and urethra Response Feedback:RATIONALE: The root cyst- means urinary bladder. The root word urethr- means urethra. A cystourethroscopy is examination of the urinary bladder and urethra. Question 10 10 out of 10 points Which leukocyte does the body use to protect against allergic reactions and parasites? Selected Answer: d. Eosinophil s Correct Answer: d. Eosinophil s Response Feedback:RATIONALE: The body uses eosinophils to protect against allergic reactions and parasites; elevated levels may indicate an allergic response. Sunday, November 19, 2017 9:05:50 AM MST Question 1 4 out of 4 points Lacrimal glands are responsible for which of the following? Selected Answer: c. Production of tearsCorrect Answer: c. Production of tears Question 2 4 out of 4 points Through which vessel is oxygenated blood returned to the heart from the lungs? Selected Answer: d. Pulmonary vein Correct Answer: d. Pulmonary vein Question 3 4 out of 4 points Which of the following conditions results from an injury to the head? The symptoms include headache, dizziness and vomiting. Selected Answer: b. Concussio n Correct Answer: b. Concussio n Question 4 4 out of 4 points The loop of Henle is located in which structure? Selected Answer: b. Kidney Correct Answer: b. Kidney Question 5 4 out of 4 points What is a function of the alveoli in the lungs? Selected Answer: b. Oxygen exchange Correct Answer: b. Oxygen exchange Question 6 4 out of 4 points Which gland is located on the superior surface of the kidney? Selected Answer: d. Adrenal gland Correct Answer: d. Adrenal gland Question 7 4 out of 4 points Upon leaving the stomach, nutrients move through the small intestine in what order?Selected Answer: a. Duodenum, jejunum, ileum. Correct Answer: a. Duodenum, jejunum, ileum. Question 8 4 out of 4 points How many lobes make up the right lung? Selected Answer: b. three Correct Answer: b. three Question 9 0 out of 4 points Which of the following is true of the stratum germinativum? Selected Answer: c. It is composed of about 30 layers of dead, flattened, keratinized cells. Correct Answer: a. It lies on top of the dermis and has access to a rich supply of blood. Question 10 4 out of 4 points Which layer is NOT considered part of the skin? Selected Answer: b. Hypodermi s Correct Answer: b. Hypodermi s Question 11 4 out of 4 points Which of the following is significant of an abdominal aortic aneurysm? Selected Answer: c. It is a weakness in a large artery and rupture can be deadly Correct Answer: c. It is a weakness in a large artery and rupture can be deadly Question 12 4 out of 4 points Which chamber of the heart is considered the one working the hardest? Selected Answer: d. Left ventricle Correct Answer: d. Left ventricle Question 13 4 out of 4 points What is a myocardial infarction?Selected Answer: b. Lack of oxygen to the heart tissue, resulting in tissue death Correct Answer: b. Lack of oxygen to the heart tissue, resulting in tissue death Question 14 4 out of 4 points The dome-shaped muscle under the lungs flattening during inspiration is the: Selected Answer: c. Diaphrag m Correct Answer: c. Diaphrag m Question 15 4 out of 4 points A condition where the thyroid is overactive is called: Selected Answer: a. Thyrotoxicosis Correct Answer: a. Thyrotoxicosis Question 16 4 out of 4 points The meaning of the root blephar/o is: Selected Answer: d. Eyeli d Correct Answer: d. Eyeli d Question 17 4 out of 4 points A deficiency of cells in the blood is defined as: Selected Answer: b. Cytopeni a Correct Answer: b. Cytopeni a Question 18 4 out of 4 points Cytopathology is the study of: Selected Answer: d. Cell s Correct d.