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AAPC CPC FINAL EXAM REAL EXAM 100
QUESTIONS AND CORRECT
ANSWERS(VERIFIED ANSWERS)|AGRADE
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