American Academy of Professional Coders (AAPC) Practice Exam

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What does the acronym NPI represent?

National Policy Identifier
National Provider Identifier
Network Participation Identification
Nursing Practice Initiative

The correct answer is: National Provider Identifier

The acronym NPI stands for National Provider Identifier. This is a unique identification number for healthcare providers in the United States. It serves to streamline the billing process and improve the efficiency of health care transactions by providing a standardized way of identifying healthcare professionals and organizations, including doctors, hospitals, and other types of providers. The NPI is used in routine healthcare administrative transactions such as electronic claims submissions and eligibility verification. Having a National Provider Identifier helps ensure that claims are correctly processed and associated with the correct provider, which is essential for both payment and maintaining proper records. The NPI is assigned by the Centers for Medicare & Medicaid Services (CMS) and it became mandatory after the adoption of the Health Insurance Portability and Accountability Act (HIPAA) in 1996. Understanding the significance of the NPI is crucial for professionals in the healthcare and medical billing fields, as it is a fundamental part of the healthcare reimbursement process.