Question 1

Which department or act was the Health Care Fraud and Abuse Control Program created by?

Accepted Answer

A)  Health Insurance Portability and Accountability Act 
B)  State attorneys general offices 
C)  Office of the National Coordinator of Health Information Technology 
D)  Health Information Security and Privacy Collaboration 
A)  Health Insurance Portability and Accountability Act 
B)  State attorneys general offices 
C)  Office of the National Coordinator of Health Information Technology 
D)  Health Information Security and Privacy Collaboration A

Question 2

Choosing a code that represents a more intense procedure than that which was actually provided is called:

Accepted Answer

A)  upcoding. 
B)  unbundling. 
C)  mutually exclusive coding. 
D)  coding for coverage. 
A)  upcoding. 
B)  unbundling. 
C)  mutually exclusive coding. 
D)  coding for coverage. A

Question 3

The following individuals are responsible for patient information in the health care practice except a(n):

Accepted Answer

A)  physician. 
B)  transporter. 
C)  insurance coder and biller. 
D)  therapist. 
A)  physician. 
B)  transporter. 
C)  insurance coder and biller. 
D)  therapist. B

Question 4

Blue Cross Blue Shield is an example of a:

Accepted Answer

A)  health care provider. 
B)  health care clearinghouse. 
C)  health community liaison. 
D)  health plan. 
A)  health care provider. 
B)  health care clearinghouse. 
C)  health community liaison. 
D)  health plan.

Question 5

What is the responsibility of a privacy officer?

Accepted Answer

A)  To review and validate the qualifications of physicians and other licensed independent practitioners 
B)  To organize patient care plans that meet the standards set forth by law for managed care plans 
C)  To recognize there is a risk that a given procedure may include functional impairment, injury, morbidity, or mortality 
D)  To develop and implement privacy policies and procedures 
A)  To review and validate the qualifications of physicians and other licensed independent practitioners 
B)  To organize patient care plans that meet the standards set forth by law for managed care plans 
C)  To recognize there is a risk that a given procedure may include functional impairment, injury, morbidity, or mortality 
D)  To develop and implement privacy policies and procedures

Question 6

Providers are not permitted to use or disclose PHI without a patient's written permission in which instance?

Accepted Answer

A)  Treatment 
B)  Payment 
C)  Operations 
D)  Detailed data sets 
A)  Treatment 
B)  Payment 
C)  Operations 
D)  Detailed data sets

Question 7

An example of a federal law is:

Accepted Answer

A)  AAPC. 
B)  AHIMA. 
C)  HIPAA. 
D)  CMS. 
A)  AAPC. 
B)  AHIMA. 
C)  HIPAA. 
D)  CMS.

Question 8

What are the two main coding professional organizations that have published a code of ethics guide?

Accepted Answer

A)  AAPC and AHIMA 
B)  AAMT and AAMC 
C)  ACHE and ACS 
D)  AHRQ and AMIA 
A)  AAPC and AHIMA 
B)  AAMT and AAMC 
C)  ACHE and ACS 
D)  AHRQ and AMIA

Question 9

________ are known as the official policies issued by the President of the United States.

Accepted Answer

A)  Administrative Laws 
B)  Common Laws 
C)  Executive Orders 
D)  Statutory Laws 
A)  Administrative Laws 
B)  Common Laws 
C)  Executive Orders 
D)  Statutory Laws

Question 10

Covered entities are defined as businesses that:

Accepted Answer

A)  provide transportation services. 
B)  have access to the personal health information of patients. 
C)  create the Health Care Fraud and Abuse Control Program. 
D)  forbid the submission of health care claims. 
A)  provide transportation services. 
B)  have access to the personal health information of patients. 
C)  create the Health Care Fraud and Abuse Control Program. 
D)  forbid the submission of health care claims.

Question 11

What were the HIPAA Privacy Rules written to protect?

Accepted Answer

A)  Coding professionals' rights 
B)  Physicians' privacy rights 
C)  An individual's personal health information 
D)  A business associate's privacy rights 
A)  Coding professionals' rights 
B)  Physicians' privacy rights 
C)  An individual's personal health information 
D)  A business associate's privacy rights

Question 12

What can the lack of accuracy of coding affect?

Accepted Answer

A)  It can directly influence reimbursement to providers. 
B)  It can correctly alter healthcare policies and guidelines. 
C)  It can direct research endeavors. 
D)  It can decrease a patient's deductible. 
A)  It can directly influence reimbursement to providers. 
B)  It can correctly alter healthcare policies and guidelines. 
C)  It can direct research endeavors. 
D)  It can decrease a patient's deductible.

Question 13

The statistics show that for every $1 spent to pay for health care fraud and abuse investigations and prosecutions, the government actually brings in about ________ in money returned.

Accepted Answer

A)  $2 
B)  $3 
C)  $4 
D)  $5 
A)  $2 
B)  $3 
C)  $4 
D)  $5

Question 14

An example of a health care provider, under HIPAA, is:

Accepted Answer

A)  a dentist. 
B)  a computer software manufacturer. 
C)  WebMD. 
D)  Abbott Health insurance. 
A)  a dentist. 
B)  a computer software manufacturer. 
C)  WebMD. 
D)  Abbott Health insurance.

Question 15

Choosing codes according to insurance company policies rather than what actually occurred with the patient is called:

Accepted Answer

A)  upcoding. 
B)  unbundling. 
C)  mutually exclusive coding. 
D)  coding for coverage. 
A)  upcoding. 
B)  unbundling. 
C)  mutually exclusive coding. 
D)  coding for coverage.

Question 16

When Dr. Sanders "uses" PHI, according to HIPAA, it means he is discussing a patient with the:

Accepted Answer

A)  pharmacist at the drug store. 
B)  radiologist at the imaging center. 
C)  appointment scheduler in his office. 
D)  lab technician at the laboratory. 
A)  pharmacist at the drug store. 
B)  radiologist at the imaging center. 
C)  appointment scheduler in his office. 
D)  lab technician at the laboratory.

Question 17

A $100 fine with no prison time is the penalty for a HIPAA:

Accepted Answer

A)  criminal violation. 
B)  civil violation. 
C)  ethical violation. 
D)  fraud conviction. 
A)  criminal violation. 
B)  civil violation. 
C)  ethical violation. 
D)  fraud conviction.

Question 18

What does the Federal False Claims Act forbid?

Accepted Answer

A)  Late submission of claims 
B)  Inaccurate submission of health care claims for financial gain 
C)  Bundled code submissions 
D)  Claims submitted with coding, supported by documentation 
A)  Late submission of claims 
B)  Inaccurate submission of health care claims for financial gain 
C)  Bundled code submissions 
D)  Claims submitted with coding, supported by documentation

Question 19

It is illegal to bill for a component service when:

Accepted Answer

A)  codes corroborate the documentation in the medical record. 
B)  codes are identified as those that are not permitted. 
C)  a comprehensive code or combination code is available. 
D)  a code is identified as a separate procedure. 
A)  codes corroborate the documentation in the medical record. 
B)  codes are identified as those that are not permitted. 
C)  a comprehensive code or combination code is available. 
D)  a code is identified as a separate procedure.

Question 20

What is an example of a health plan, under HIPAA?

Accepted Answer

A)  County health department 
B)  Aetna health insurance 
C)  WebMD Network Services 
D)  Home health aide 
A)  County health department 
B)  Aetna health insurance 
C)  WebMD Network Services 
D)  Home health aide

Exam 36: Introduction to Health Care Law and Ethics

Which department or act was the Health Care Fraud and Abuse Control Program created by?

Choosing a code that represents a more intense procedure than that which was actually provided is called:

The following individuals are responsible for patient information in the health care practice except a(n):

Blue Cross Blue Shield is an example of a:

What is the responsibility of a privacy officer?

Providers are not permitted to use or disclose PHI without a patient's written permission in which instance?

An example of a federal law is:

What are the two main coding professional organizations that have published a code of ethics guide?

________ are known as the official policies issued by the President of the United States.

Covered entities are defined as businesses that:

What were the HIPAA Privacy Rules written to protect?

What can the lack of accuracy of coding affect?

The statistics show that for every $1 spent to pay for health care fraud and abuse investigations and prosecutions, the government actually brings in about ________ in money returned.

An example of a health care provider, under HIPAA, is:

Choosing codes according to insurance company policies rather than what actually occurred with the patient is called:

When Dr. Sanders "uses" PHI, according to HIPAA, it means he is discussing a patient with the:

A $100 fine with no prison time is the penalty for a HIPAA:

What does the Federal False Claims Act forbid?

It is illegal to bill for a component service when:

What is an example of a health plan, under HIPAA?

Introduction to the Languages of Coding

Abstracting Clinical Documentation

The Coding Process

Introduction to Icd-10-Cm

Coding Infectious Diseases

Coding Neoplasms

Coding Conditions of the Blood and Immunological Systems

Coding Endocrine Conditions

Coding Mental, Behavioral, and Neurological Disorders

Coding Dysfunction of the Optical and Auditory Systems

Coding Cardiovascular Conditions

Coding Respiratory Conditions

Coding Digestive System Conditions

Coding Integumentary Conditions

Coding Muscular and Skeletal Conditions

Coding Injury, Poisoning, and External Causes

Coding Genitourinary, Gynecology, Obstetrics, Congenital, and Pediatrics Conditions

Factors Influencing Health Status Z Codes

Inpatient Hospital Diagnosis Coding

Introduction to CPT

CPT and Hcpcs Level Ii Modifiers

CPT Evaluation and Management Coding

CPT Anesthesia Section

CPT Surgery Section

CPT Radiology Section

CPT Pathology Lab Section

CPT Medicine Section

Hcpcs Level II

Introduction to Icd-10-Pcs

ICD-10-Pcs Medical and Surgical Section

Obstetrics Section

Placement Through Chiropractic Sections

Imaging, Nuclear Medicine, and Radiation Therapy Sections

Physical Rehabilitation and Diagnostic Audiology Through New Technology Section

Reimbursement

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