AAPC Training

Select the TRUE statement regarding ABNs

• • ABNs may not be recognized by non-Medicare payers.

• ABNs must be signed for emergency or urgent care.

• ABNs are not required to include an estimate cost for the service.

• • ABNs should be routinely signed by Medicare Beneficiaries in case Medicare doesn't cover a service.

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?

• • $25 or 10 percent

• • $100 or 10 percent

• • $100 or 25 percent

• • An exact amount

• What document assists provider offices with the development of Compliance Manuals?

• • OIG Compliance Program Guidance

• • OIG Work Plan

• OIG Suggested Rules and Regulations

• • OIG Internal Compliance Plan

What document is referenced to when looking for potential problem areas identified by the government indicating scrutiny of the services?

• • OIG Compliance Program Guidance

• • OIG Security Summary

• • OIG Work Plan

• • OIG Investigation Plan

Who would NOT be considered a covered entity under HIPAA?

• Doctors

• HMOs

• Clearinghouses

• Patients

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?

• • LCD

• CMS-1500

• • UB-04

• • ABN

According to the example LCD from Novitas Solutions, which of the following conditions is considered a systemic condition that may result in the need for routine foot care?

• • Arthritis

• Chronic venous insufficiency

• • Hypertension

• Muscle weakness

Under HIPAA, what would be a policy requirement for “minimum necessary”?

• • Only individuals whose job requires it may have access to protected health information.

• Only the patient has access to his or her own protected health information.

• • Only the treating provider has access to protected health information.

• • Anyone within the provider’s office can have access to protected health information.

• Which act was enacted as part of the American Recovery and Reinvestment Act of 2009 (ARRA) and affected privacy and security?

• • HIPAA

• • HITECH

• • SSA

• • PPACA

Which statement describes a medically necessary service?

• Performing a procedure/service based on cost to eliminate wasteful services.

• Using the least radical service/procedure that allows for effective treatment of the patient’s

• • Using the closest facility to perform a service or procedure.

• • Using the appropriate course of treatment to fit within the patient’s lifestyle.