HIPPA AND HCPCS-CPC repeated questions 2023

• HIPAA - Health insurance portability and accountability act

• Skilled Nursing facility – part A(repeated)
• Fraud
• NCCI National correct coding initiative
• BCBS
• Medicare A,B (repeated)
• POS place of service (22, 24
• ABN Advance Beneficiary Notice

An Advance Beneficiary Notice (ABN), also known

as a waiver of liability, is a notice a provider should
give you before you receive a service if, based on
Medicare coverage rules, your provider has reason
to believe Medicare will not pay for the service
Only apply if you are in the original medicare plan
• A0429,A0426
• Rituximab 800 mg
• J9312
• PHI protected health information

• Workers compensation(repeated)
• QW,SH (repeated)
• G0008,G0009
• RVU relative value units
Medicare reimbursement payments are made to
beneficiaries who pay Medicare's portion of their bill
out-of-pocket. Medicare reimbursement also can
refer to payments made to doctors who accept
Medicare assignment and perform healthcare
services.
Used in Medicare reimbursement formula for physician services A payment formula contains 3
RVUs One for practice expense One for malpractice expense One for physician work - 3 RVUs
of a given service are multiplied by a unique geographic practice cost index referred as GPCI
adjustment. - - - The sum of 3 geographically weighted RVU value is then multiplied by
Medicare Conversion Factor to obtain a final price.

• A0160
• QH,QM
• Chemotherapy drug injections
• Ambulance basic life support(A0428,A0429)
• G0129
• Blue cross , blue shield - Private sector
• OIG
• Ambulance service- accident place to hospital
• CMS
• AMA
• OCR
• A0130
• PTP
• G8
• A4222
• Purpose of
• abuse
• Preventive examination done during same visit a ECG and one
vaccination done. (G0402, G0403, 90471...)
• Fiberglass cast long arm
• RBRVS ( Resource based relative value scale) Resource.
• QM, QS, QC, QY,QA
• Entity that promote compliance
• G009
• G0402,G0403
• Part D cover drugs
• Place of service 22( outpatient surgery)
• GS
• MI
• J Series + vaccination codes
• J2704
• A codes
• G Codes
• G0404,G0008
• not covered under hippa -work compensation
• Ambulance service basic support
 • QW CLIA
• Example of medical necessity - 1. speech therapy 2. To make
nose smaller size etc.
• G0121
• A0225
• Hcpcs + cpt mixed question
• POS11,21,24
• NCD
• Glucose monitoring device
• Emergency ambulatory
• Hcpcs with vaccine code
• G0402 G0403 G0404 G0405 with E and M cod (confsng)