AAPC AAPC Certifications AAPC-CPB Questions & Answers

• Question 161:

  ankyl

  A. against

  B. joint

  C. condition

  D. crooked, bent

  Correct Answer: D

• Question 162:

  Adverse Selection includes covering members who are sicker then the general population.

  A. TRUE

  B. FALSE

  Correct Answer: A

• Question 163:

  What is Allowed Charge?

  A. The Maximum amount the payer will reimburse for each procedure or service, according to the patients policy.

  B. The Minimum amount the payer will reimburse for each procedure or service, according to the patients policy.

  C. The amount the payer will reimburse for each procedure or service, according to the patients policy.

  Correct Answer: A

• Question 164:

  Capitation

  A. Provider accepts preestablished payments for providing healthcare services to enrollees over a period of time (usually one quarter)

  B. Provider accepts preestablished payments for providing healthcare services to enrollees over a period of time (usually one month)

  C. Provider accepts preestablished payments for providing healthcare services to enrollees over a period of time (usually 6 months)

  D. Provider accepts preestablished payments for providing healthcare services to enrollees over a period of time (usually one year)

  Correct Answer: D

• Question 165:

  What does BSR stand for?

  A. Beneficiary Standards Representative

  B. Beneficiary Services Representative

  C. Blue Shield Representative

  D. Black Shield Representative

  Correct Answer: B

• Question 166:

  ERISA

  A. First Look Analysis for Hospital Outlier Monitoring

  B. False Claims Act

  C. Fair Debt Collection Practices Act

  D. Employee Retirements Income Security Act of 1974

  Correct Answer: D

• Question 167:

  What is All Patient Refined DiagnosisRelated Group (ARPDRG)?

  A. Adopted by Medicare in 2008 to reimburse hospitals for inpatient care provided to Medicare beneficiaries; expanded original DRG system (based on intensity of resources) to add two subclasses to each DRG that adjusts Medicare inpatient hospital reimbursement rates for severity of illness (SOI) (extent of physiological decompensation or organ system loss of function) and risk of mortality (ROM) (likelihood of dying); each subclass, in turn, is subdivided into four areas: (1) minor, (2) moderate, (3) major, (4) extreme.

  B. DRG system adapted for use by third-party payers to reimburse hospitals for inpatient care provided to nonMedicare beneficiaries (e.g. Blue Cross BlueShield, commercial health plans, TRICARE); DRG assignment is based on intensity of resources.

  Correct Answer: A

• Question 168:

  Adjusted Claim is payment correction resulting in additional payment(s) to the provider.

  A. TRUE

  B. FALSE

  Correct Answer: A

• Question 169:

  E/M

  A. Electronic Media Claim

  B. Electronic Medical Record

  C. of Benefits

  D. Evaluation and Management

  Correct Answer: D

• Question 170:

  Which part of the body does cervic refer to?

  A. vagina

  B. head

  C. skull

  D. neck

  Correct Answer: D