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Ch1 test

Med'l bsns

Question	Answer
1. When coding an operative report, what action would NOT be recommended?	Coding from the header without reading the body of the report.
2. 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?	Research
3. A covered entity does NOT include	patients
4. Local Coverage Determinations are administered by whom?	Each regional MAC
5. Many coding professionals go on to find work as:	consultants
6. According to the OIG, internal monitoring and auditing should be performed by what means?	periodic audits
7. Which CMS product describes whether specific medical items, services, treatment procedures or technologies are considered medically necessary under Medicare?	National Coverage Determinations Manual
8. 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.	fraudulent claims
9. HITECH provides a ____ day window during which any violation not due to willful neglect may be corrected without penalty.	30
10. Which provider is NOT a mid-level provider?	Anesthesiologist
11. Which coding manuals do outpatient coders focus on learning?	CPT®, HCPCS Level II and ICD-10-CM
12. What type of insurance is Medicare Part D?	Prescription drug coverage available to all Medicare beneficiaries.
13. Evaluation and management services are often provided in a standard format such as SOAP notes. What does the acronym SOAP stand for?	Subjective, Objective, Assessment, Plan
14. What will the scope of a compliance program depend on?	a. The size and resources of the provider’s practice
15. What type of health insurance provides coverage for low-income families?	Medicaid
16. What does CMS-HCC stand for?	b. Centers for Medicare & Medicaid Services – Hierarchal Condition Category
17. The AAPC offers over 500 local chapters across the country for the purpose of	Continuing education and networking
18. The OIG releases a ____ outlining its priorities for the fiscal year ahead and beyond.	work plan
19. How many components are included in an effective compliance plan?	7
20. 20. What form is used to submit a provider’s charge to the insurance carrier?	CMS-1500
21. The Medicare program is made up of several parts. Which part covers provider fees without the use of a private insurer?	Part B
22. The OIG recommends that provider practices enforce disciplinary actions through well publicized compliance guidelines to ensure actions that are ______.	Consistent and appropriate
23. LCDs only have jurisdiction in their ____.	region
In what year was HITECH enacted as part of the American Recovery and Reinvestment Act?	2009
25. Healthcare providers are responsible for developing ____ ____ and policies and procedures regarding privacy in their practices.	notices of privacy practices
Professionals who specialize in coding are called:	Coding specialists
What does the abbreviation MAC stand for?	Medicare Administrative Contractor
What is the value of a remittance advice?	It states what will be paid and why any changes to charges were made.
What is the purpose of National Coverage Determinations?	To explain CMS policies on when Medicare will pay for items or services
What is PHI?	Protected health information
Which type of information is NOT maintained in a medical record?	Financial records
Who is responsible for enforcing the HIPAA security rule?	The Office for Civil Rights (OCR) enforces the HIPAA Security Rule.
EHR stands for?	Electronic health record
If an NCD does not exist for a particular service/procedure performed on a Medicare patient, who determines coverage?	Medicare Administrative Contractor (MAC)
What type of provider goes through approximately 26.5 months of education, after completion of a bachelor’s degree, and is licensed to practice medicine with the oversight of a physician?	Physician Assistant (PA)

Created by: Merc9496

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