Description

Physician Coding for CPC Preparation

Question 1
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.
 Question 2
0 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:
d.
muscle
weakness
Correct
Answer:
b.
fibromyalgia
Response
Feedback:
Rationale: According to the LCD, measurement of vitamin D levels is
indicated for patients with fibromyalgia.
 Question 3
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 4
0 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:
a.
HIPAA
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 5
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 6
0 out of 10 points
What document assists provider offices with the development of Compliance Manuals?
Selected
Answer:
c.
OIG Suggested Rules and Regulations
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 7
10 out of 10 points
Who would NOT be considered a covered entity under HIPAA?
Selected d.
Answer: 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
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 9
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 10
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.
Thursday, September 21, 2017 7:47:13 PM MD