Compliance Important Questions For CPC Exam

 

Hello Readers , Welcome to Medico Pediaa , Today I will explain about Top 20 Compliance Important Questions For CPC Exam. Preparing for the CPC (Certified Professional Coder) Exam is not just about mastering coding guidelines—it also requires a solid understanding of compliance and regulatory concepts. These questions are a crucial part of the exam because they test a candidate’s ability to follow ethical standards, legal requirements, and coding compliance rules in real-world healthcare scenarios.

Compliance ensures that medical coders work within the HIPAA guidelines, fraud and abuse laws, OIG regulations, and payer policies, while regulatory knowledge helps coders apply coding standards accurately. In today’s healthcare industry, even a small mistake in compliance can lead to audits, penalties, or claim denials. Compliance Important Questions For CPC Exam

Q1. What type of Health insurance provides coverage for low- income families?

(a) Medicaid 

(b) Commercial PPO

(c) Medicare

(d) Commercial HMO

 

Q2. Who is responsible for enforcing the HIPAA security rule ?

(a) OIG

(b) OCR

(c) HHS

(d) CMS

 

Q3. Which option below is not covered entity under HIPAA ?

(a) Medicare

(b) BCBS 

(c) Medicaid 

(d) Worker’s compensation 

 

Q4. Which of the following is a benefit of electronic transactions ?

(a) Payment of claims

(b) Timely submission of claims 

(c) Security of claims 

(d) None of the above 

 

Q5. What form is used to submit a providers charge to the insurance carrier ?

(a) UB-04

(b) ABN

(c) CMS-1500

(d) Provider reimbursement form

 

Q6. Which of the following services are covered by Medicare part D ?

(a) Inpatient chemotherapy 

(b) Minor surgery performed in a physicians office 

(c) Prescription drugs 

(d) Skilled nursing facility services 

 

Q7. AAPC credentialed coders have proven mastery of what information ?

(a) Code sets

(b) Evaluation and management principles 

(c) Documentation guidelines 

(d) All of the above 

 

Q8. Local coverage determination are administered by ?

(a) NCD’S 

(b) State law 

(c) Each regional MAC

(d) NCCI

 

Q9. A covered entity may obtain consene of the individual to use or disclose PHI to carry out all what of the following?

(a) For public use 

(b) Payment 

(c) Treatment 

(d) Healthcare operiations 

 

Q10. What is a NPI ?

(a) National payer incentive 

(b) National provide index

(c) National payer identification 

(d) National provider identifier

 

Compliance And Regulatory Questions For CPC Exam :- https://medicopediaa.com/compliance-and-regulatory-questions-for-cpc-exam/

 

Q11. Which act was enacted as part of the American Recovery and reinvestment Act of 2009 and affected privacy and security?

(a) HIPAA 

(b) HITECH 

(c) SSA 

(d) PPACA

 

Q12. The AAPC offers over 500 local chapters across the country for the purpose of 

(a) Membership dues

(b) Continuing education and networking 

(c) Regulations and by laws 

(d) Financial management 

 

Q13. In what year did HIPAA became a law ?

(a) 1995

(b) 1996

(c) 1997

(d) 1993

 

Q14. The 2012 OIG work plan priorities which of the following topics for review ?

(a) Fracture repair 

(b) Dystrophic nail care 

(c) Lesion removal 

(d) E/M service during global surgery periods

 

Q15. The Medicare program is made up of several parts which part covers provider fees without the use of a private insurer ?

(a) Party B

(b) Part A

(c) Part C

(d) Part D

 

Q16. Which of the following choices is not a benefit of an active compliance plan ?

(a) Eliminates risk of an audit 

(b) Fewer billing mistakes

(c) Increases accuracy of provider documentation 

(d) More accurate payment of claims 

 

Q17. Which provider is not a mid-level provier ?

(a) Anesthesiologist 

(b) All choices and mid-level providers

(c) Physician assistant 

(d) Nurse practitioners 

 

Q18. What document assists provider offices with development of compliance manuals ? 

(a) OIG complan plan guidance 

(b) OIG workplan

(c) OIG suggested rules and regulations 

(d) OIG internal compliance plan 

 

Q19. LCD’s only have jurisdiction in their?

(a) Locality 

(b) Region 

(c) State 

(d) District 

 

Q20. What does MAC stands for?

(a) Medicaid Administrative contractor 

(b) Medicare Administrative contractor 

(c) Medicare Advisory contractor 

(d) Medicaid alert contractor 

 

Answer 

 

1 – A ,       2– B  ,     3- D,       4-B ,     5 – C,     6-C ,   7- D,       8-C,        9-A,       10 -D ,       

11-A ,        12-B ,  13–B  ,  14-D ,     15-A,      16- A ,   17 – A ,     18 -A ,   19 -B,    20-B

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