The term for the set payment that the member pays to the healthcare provider on the day of service is the:



a. office visit fee.

b. co-insurance.

c. copay.

d. co-signer. - correct answer c. copay.



Blue Cross/Blue Shield identifies the individual or employee who pays for healthcare insurance ...
My AAPC CPB - Chapter 12 Review Exam Questions And Answers Graded A+
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The term for the set payment that the member pays to the healthcare provider on the day of service is the:



a. office visit fee.

b. co-insurance.

c. copay.

d. co-signer. - correct answer c. copay.



Blue Cross/Blue Shield identifies the individual or employee who pays for healthcare insurance ...
Abuse - correct answer An action that results in unnecessary costs to a federal healthcare program, directly or indirectly.



Anti-kickback - correct answer Knowingly and willfully offering or accepting rewards or remuneration for services that are billable to a federal healthcare plan.



Benefiic...
CPB Exam Questions And Verified Answers
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Abuse - correct answer An action that results in unnecessary costs to a federal healthcare program, directly or indirectly.



Anti-kickback - correct answer Knowingly and willfully offering or accepting rewards or remuneration for services that are billable to a federal healthcare plan.



Benefiic...
QUIZ - correct answer QUIZ



According to OSHA, who has the highest rate of work-related musculoskeletal disorders?



a. Movers

b. Welders

c. Nurses aids

d. Manufacturers - correct answer c. Nurses aids



Can an employer require an employee to pay a portion of the insurance premiums for the wo...
CPB Chapter 14: Workers' Compensation Test Questions And Answers
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QUIZ - correct answer QUIZ



According to OSHA, who has the highest rate of work-related musculoskeletal disorders?



a. Movers

b. Welders

c. Nurses aids

d. Manufacturers - correct answer c. Nurses aids



Can an employer require an employee to pay a portion of the insurance premiums for the wo...
Abuse - correct answer Actions inconsistent with accepted, sound medical business or fiscal practice



Accept Assignment - correct answer Provider accepts as payment in full whatever is paid on the cliam by the payer (except for any copayment and or coinsurance amounts.)



Accounts Receivable - co...
CPB Certified Professional Biller Certification Post Test Exam And Quality Answers .
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Abuse - correct answer Actions inconsistent with accepted, sound medical business or fiscal practice



Accept Assignment - correct answer Provider accepts as payment in full whatever is paid on the cliam by the payer (except for any copayment and or coinsurance amounts.)



Accounts Receivable - co...
A patient's insurance member card is issued by:



a. the insurance company.

b. the state.

c. the employer.

d. the physician's office. - correct answer a. the insurance company



The best practice to prevent a non-covered service denial would be to:



a. determine what documentation is needed...
CPB Certification Chapter 12 End Of Semester Exam Well Answered
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A patient's insurance member card is issued by:



a. the insurance company.

b. the state.

c. the employer.

d. the physician's office. - correct answer a. the insurance company



The best practice to prevent a non-covered service denial would be to:



a. determine what documentation is needed...
Local Coverage Determination (LCD) - correct answer Decision made by a fiscal intermediary (FI) or a Medicare carrier about the services and items that are reasonable and necessary. LCD also decides if a particular service should be covered on an intermediary-wide basis, and it makes decisions about...
CPB AAPC CH 7 Post Test Exam Questions With Complete Solutions
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Local Coverage Determination (LCD) - correct answer Decision made by a fiscal intermediary (FI) or a Medicare carrier about the services and items that are reasonable and necessary. LCD also decides if a particular service should be covered on an intermediary-wide basis, and it makes decisions about...
What is the term for the total amount of covered medical expenses a policyholder must pay each year out-of-pocket before the health insurance company begins to pay any benefits? - correct answer A deductible is the amount a policyholder pays for health care services before the health insurance begin...
AAPC CPB Final Exam Questions And Answers
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What is the term for the total amount of covered medical expenses a policyholder must pay each year out-of-pocket before the health insurance company begins to pay any benefits? - correct answer A deductible is the amount a policyholder pays for health care services before the health insurance begin...
ICD-10-CM Layout - correct answer -Coding Conventions

-Official ICD-10 Guidelines for Coding and Reporting

-Index to Diseases and Injuries (Alphabetic Index)

-Table of Neoplasms

-Table of Drugs and Chemicals

-Index to External Cause of Injuries

-Tabular List



ICD-10-CM Alphabetic Index or In...
AAPC CPB Training Chapter 4: Intro to ICD-10-CM Study Guide Exam And Answers 100% Verified .
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ICD-10-CM Layout - correct answer -Coding Conventions

-Official ICD-10 Guidelines for Coding and Reporting

-Index to Diseases and Injuries (Alphabetic Index)

-Table of Neoplasms

-Table of Drugs and Chemicals

-Index to External Cause of Injuries

-Tabular List



ICD-10-CM Alphabetic Index or In...
Joe and Mary are a married couple and both carry insurance from their employers. Joe was born on February 23, 1977 and Mary was born on April 4, 1974. Using the birthday rule, who carries the primary insurance for their children for billing?



A. Joe, because he is the male head of the household.
...
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Joe and Mary are a married couple and both carry insurance from their employers. Joe was born on February 23, 1977 and Mary was born on April 4, 1974. Using the birthday rule, who carries the primary insurance for their children for billing?



A. Joe, because he is the male head of the household.
...
covered entity - correct answer Health plan, clearinghouses, and any entity transmitting health information is considered by the Privacy Rule to be a:



healthcare consulting firm - correct answer Which of the following is not a covered entity in the Privacy Rule



release reqt to ins co - correct...
AAPC CPB Final Exam And Correct Complete Answers
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covered entity - correct answer Health plan, clearinghouses, and any entity transmitting health information is considered by the Privacy Rule to be a:



healthcare consulting firm - correct answer Which of the following is not a covered entity in the Privacy Rule



release reqt to ins co - correct...
Health plan, clearinghouses, and any entity transmitting health information is considered by the Privacy Rule to be a: - correct answer covered entity



Which of the following is not a covered entity in the Privacy Rule - correct answer healthcare consulting firm



A request for medical records is...
AAPC CPB Final Exam Questions And Answers Rated A+
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Health plan, clearinghouses, and any entity transmitting health information is considered by the Privacy Rule to be a: - correct answer covered entity



Which of the following is not a covered entity in the Privacy Rule - correct answer healthcare consulting firm



A request for medical records is...
HIPPA OF 1996 includes a security rule that is established to provide what national stands for protecting and transmitting patient data. Which of the following is NOT true?

A) The security rule applies to healthcare providers, health plans, and any covered entity involved in the care of a patient....
AAPC CPB Final Exam Study Guide Exam With Verified Solutions
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HIPPA OF 1996 includes a security rule that is established to provide what national stands for protecting and transmitting patient data. Which of the following is NOT true?

A) The security rule applies to healthcare providers, health plans, and any covered entity involved in the care of a patient....
Which denial occurs when the claim is a liability case and was submitted to the health insurance?



a. Coordination of Benefits

b. Request for medical records

c. Claim not covered by insurer

d. Claim covered by other insurer - correct answer d. Claim covered by other insurer



Similar to a coor...
AAPC CPB Chapter 13 Exam Review Questions And Verified Answers
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Which denial occurs when the claim is a liability case and was submitted to the health insurance?



a. Coordination of Benefits

b. Request for medical records

c. Claim not covered by insurer

d. Claim covered by other insurer - correct answer d. Claim covered by other insurer



Similar to a coor...
Use CPB Chapter 12_Case to answer questions 1 and 2.



After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect?



I. Type of Insurance

II. Primary insurance policy number

III. Primary group number

IV. Federal Tax ID number

V. Billi...
AAPC CPB Chapter 12 Practical Application Exam Questions And Answers
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Use CPB Chapter 12_Case to answer questions 1 and 2.



After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect?



I. Type of Insurance

II. Primary insurance policy number

III. Primary group number

IV. Federal Tax ID number

V. Billi...
Which coverage under TRICARE is a Medicare wrap around plan?



a. TRICARE for Life

b. TRICARE Reserve Select

c. TRICARE Prime

d. CHAMPVA - correct answer a. TRICARE for Life



A patient has Medicare and a Medigap policy. Box 13, signature on file, is checked off on the electronic claim submissi...
AAPC CPB Chapter 11-14 Exam Assisgnment Questions And Answers 100% Verified
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Which coverage under TRICARE is a Medicare wrap around plan?



a. TRICARE for Life

b. TRICARE Reserve Select

c. TRICARE Prime

d. CHAMPVA - correct answer a. TRICARE for Life



A patient has Medicare and a Medigap policy. Box 13, signature on file, is checked off on the electronic claim submissi...
A Medicare patient presents with an injury sustained at his part-time job. His injury status is verified by his company. After services are rendered, in what order are the claims submitted?



a. The worker's compensation is primary, and Medicare is secondary



b. Either may be filed first, whiche...
AAPC CPB Chapter 11 Review Test Questions And Answers
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A Medicare patient presents with an injury sustained at his part-time job. His injury status is verified by his company. After services are rendered, in what order are the claims submitted?



a. The worker's compensation is primary, and Medicare is secondary



b. Either may be filed first, whiche...
Use CPB Chapter 11_Case to answer questions 1 & 2.



After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect?



I. The provider must accept assignment

II. Provider name conflict

III. Medicare ID number is missing information

IV. Med...
AAPC CPB Chapter 11 Practical Practice Exam Questions With Correct Solutions .
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Use CPB Chapter 11_Case to answer questions 1 & 2.



After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect?



I. The provider must accept assignment

II. Provider name conflict

III. Medicare ID number is missing information

IV. Med...
What is the first step in working a denied claim?



a. Resubmit the claim

b. Contact the carrier

c. Appeal the claim

d. Determine and understand why the claim was denied - correct answer d. Determine and understand why the claim was denied



The first step in working a denied claim is to unders...
AAPC CPB Chapter 10 Review Test Solve Correctly .
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What is the first step in working a denied claim?



a. Resubmit the claim

b. Contact the carrier

c. Appeal the claim

d. Determine and understand why the claim was denied - correct answer d. Determine and understand why the claim was denied



The first step in working a denied claim is to unders...
A patient with ABC insurance is seen on May 1st, and the claim is submitted on July 15 of the same year. Has the claim met the timely filing deadline?



a. Yes. All payers have the same timely filing deadline of one year from date of service.



b. No. All payers have a 30-day timely filing deadlin...
AAPC CPB Chapter 9 Review Study Guide Exam And Answers Rated A+ .
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A patient with ABC insurance is seen on May 1st, and the claim is submitted on July 15 of the same year. Has the claim met the timely filing deadline?



a. Yes. All payers have the same timely filing deadline of one year from date of service.



b. No. All payers have a 30-day timely filing deadlin...
Who were the NCCI edits originally developed to be used by?



a. Commercial Carriers

b. Medicare Administrative Contractors

c. Self-pay patients

d. Medicare beneficiaries - correct answer b. Medicare Administrative Contractors



The NCCI edits have column 1 and Column 2 codes and provide an ind...
AAPC CPB Chapter 7 Review post Test Exam And Correct Answers
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Who were the NCCI edits originally developed to be used by?



a. Commercial Carriers

b. Medicare Administrative Contractors

c. Self-pay patients

d. Medicare beneficiaries - correct answer b. Medicare Administrative Contractors



The NCCI edits have column 1 and Column 2 codes and provide an ind...
Patient is given 15 mg of methotrexate sodium IM for rheumatoid arthritis given from 5 mg vials. What HCPCS Level II code and unit(s) is reported?



a. J8610 x 6

b. J9260

c. J9250 x 5

d. J9250 x 3 - correct answer d. J9250 x 3



Look in the HCPCS Level II Table of Drugs for Methotrexate Sodium,...
AAPC CPB Chapter 6 Review Final Exam Solved Correctly
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Patient is given 15 mg of methotrexate sodium IM for rheumatoid arthritis given from 5 mg vials. What HCPCS Level II code and unit(s) is reported?



a. J8610 x 6

b. J9260

c. J9250 x 5

d. J9250 x 3 - correct answer d. J9250 x 3



Look in the HCPCS Level II Table of Drugs for Methotrexate Sodium,...
Acute - correct answer A condition with a rapid and short course.



Anatomical - correct answer Body site.



And - correct answer Can mean either "and" or "or" when it is in the code description.



Brackets [ ] - correct answer Symbol to enclose synonyms, alternate wording, or explanatory phr...
AAPC CPB Chapter 4 Assessment Test With Correct Solutions
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Acute - correct answer A condition with a rapid and short course.



Anatomical - correct answer Body site.



And - correct answer Can mean either "and" or "or" when it is in the code description.



Brackets [ ] - correct answer Symbol to enclose synonyms, alternate wording, or explanatory phr...
Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction?



a. Payment and remittance advice

b. Eligibility in a health plan

c. Coordination of benefits

d. Physician unique identifier number - co...
AAPC CPB Chapter 1-5 End Of Semester Final Exam With Correct Solutions .
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Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction?



a. Payment and remittance advice

b. Eligibility in a health plan

c. Coordination of benefits

d. Physician unique identifier number - co...
FCA - correct answer False Claims Act (FCA): {"knowing" and "knowingly"}-Federal statue setting civil and criminal penalties to protect the government from being overcharged or sold substandard goods or services:

-falsely billing the government

-over-representing the amount of a delivered pro...
AAPC CPB Chapter 1 Review Final Exam And Correct Answers
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FCA - correct answer False Claims Act (FCA): {"knowing" and "knowingly"}-Federal statue setting civil and criminal penalties to protect the government from being overcharged or sold substandard goods or services:

-falsely billing the government

-over-representing the amount of a delivered pro...
What is the term for the total amount of covered medical expenses a policyholder must pay each year out-of-pocket before the health insurance company begins to pay any benefits?



A. Copayment

B. Deductible

C. Secondary Payment

D. Coinsurance - correct answer B. Deductible



Which type of i...
AAPC CPB - Practice Exam B Solved Correctly 100%
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What is the term for the total amount of covered medical expenses a policyholder must pay each year out-of-pocket before the health insurance company begins to pay any benefits?



A. Copayment

B. Deductible

C. Secondary Payment

D. Coinsurance - correct answer B. Deductible



Which type of i...
What type of state worker's compensation coverage allows an employer to set aside money to cover medical expenses and other related benefits for its employees?



a. State insurance fund

b. Self-insurance plans

c. Commercial workers' compensation insurance

d. Combination program - correct answe...
AAPC CPB - Chapter 14 Quiz Study Guide Test Questions And Verified Answers
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What type of state worker's compensation coverage allows an employer to set aside money to cover medical expenses and other related benefits for its employees?



a. State insurance fund

b. Self-insurance plans

c. Commercial workers' compensation insurance

d. Combination program - correct answe...
On 05/02/19, a claim for a fine needle aspiration biopsy with ultrasound guidance was reported with CPT code 10022, ICD-10-CM code D49.2 for DOS 05/01/2019. Why would the claim be denied?



a. Not medically necessary

b. Invalid CPT code for DOS

c. Invalid ICD-10-CM code for DOS

d. Timely filing ...
AAPC CPB - Chapter 13 Review Actual Test Well Answered .
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On 05/02/19, a claim for a fine needle aspiration biopsy with ultrasound guidance was reported with CPT code 10022, ICD-10-CM code D49.2 for DOS 05/01/2019. Why would the claim be denied?



a. Not medically necessary

b. Invalid CPT code for DOS

c. Invalid ICD-10-CM code for DOS

d. Timely filing ...
Which of the following denials is one of the leading reasons a claim is denied and can be prevented by accurate intake information being collected every time?



a. Medical necessity

b. Coordination of Benefits

c. Request for medical records not received

d. Incorrect patient information - correct...
AAPC CPB - Chapter 13 Quiz 2 Actual End Of Semester Exam With Correct Solutions
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Which of the following denials is one of the leading reasons a claim is denied and can be prevented by accurate intake information being collected every time?



a. Medical necessity

b. Coordination of Benefits

c. Request for medical records not received

d. Incorrect patient information - correct...
The term for the set payment that the member pays to the healthcare provider on the day of service is the:



a. office visit fee.

b. co-insurance.

c. copay.

d. co-signer. - correct answer c. copay.



Blue Cross/Blue Shield identifies the individual or employee who pays for healthcare insurance ...
AAPC CPB - Chapter 12 Review Assessement Exam With Correct Solutions
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The term for the set payment that the member pays to the healthcare provider on the day of service is the:



a. office visit fee.

b. co-insurance.

c. copay.

d. co-signer. - correct answer c. copay.



Blue Cross/Blue Shield identifies the individual or employee who pays for healthcare insurance ...
Which type of insurance plan is a federal and state program that provides coverage to the low-income population?



a. Medicare

b. HMO

c. Medicaid

d. PPO - correct answer c. Medicaid



What is the correct action when a claim has been submitted to BCBS but the provider has not received a response...
AAPC CPB - Chapter 12 Quiz Post Test Well Answered Rated A+
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Which type of insurance plan is a federal and state program that provides coverage to the low-income population?



a. Medicare

b. HMO

c. Medicaid

d. PPO - correct answer c. Medicaid



What is the correct action when a claim has been submitted to BCBS but the provider has not received a response...
Medicare's payment amount for services are determined by which of the following formulas?



a. Sustainable growth rate (SGR) X Geographic Practice Cost Index (GPCI) = Medicare payment

b. Total RVU X Conversion factor = Medicare payment

c. Total Practice Expense (PE) X Conversion factor = Medicar...
AAPC CPB - Chapter 11 Review Training Unit Exam Well Answered 100%
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Medicare's payment amount for services are determined by which of the following formulas?



a. Sustainable growth rate (SGR) X Geographic Practice Cost Index (GPCI) = Medicare payment

b. Total RVU X Conversion factor = Medicare payment

c. Total Practice Expense (PE) X Conversion factor = Medicar...
Which statement is TRUE regarding the Prompt Payment Act?



a. Patients are required to pay patient balances within 30 days.

b. Patient balances are dismissed if a statement is not sent to the patient within 30 days.

c. Federal agencies are not required to respond to all clean claims within 30 da...
AAPC CPB - Chapter 10 Review Post Test Verified Latest Answers
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Which statement is TRUE regarding the Prompt Payment Act?



a. Patients are required to pay patient balances within 30 days.

b. Patient balances are dismissed if a statement is not sent to the patient within 30 days.

c. Federal agencies are not required to respond to all clean claims within 30 da...
What is the first step in working a denied claim?



a. Resubmit the claim

b. Contact the carrier

c. Appeal the claim

d. Determine and understand why the claim was denied - correct answer d. Determine and understand why the claim was denied



Which of the following is the highest level of the ap...
AAPC CPB - Chapter 10 Quiz B Post Test And VerifiedLatest Answers
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What is the first step in working a denied claim?



a. Resubmit the claim

b. Contact the carrier

c. Appeal the claim

d. Determine and understand why the claim was denied - correct answer d. Determine and understand why the claim was denied



Which of the following is the highest level of the ap...
A ______ indicates the location or type of service provided for an inpatient and is reported with _______.



a. Revenue code; four-digit code

b. Revenue code; three-digit code

c. CPT code; five-digit code

d. MSDRG code; three-digit code - correct answer a. Revenue code; four-digit code



Which ...
AAPC CPB - Chapter 9 Review Exam With Correct Solutions
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A ______ indicates the location or type of service provided for an inpatient and is reported with _______.



a. Revenue code; four-digit code

b. Revenue code; three-digit code

c. CPT code; five-digit code

d. MSDRG code; three-digit code - correct answer a. Revenue code; four-digit code



Which ...
When a claim has been paid, an EOB is sent to:



a. the clearinghouse.

b. the patient.

c. the provider.

d. the insurance company. - correct answer b. the patient.



Cost based fee schedules are developed using which of the following:



a. RBRVS methodology

b. total costs of every procedure o...
AAPC CPB - Chapter 9 Quiz B With Correct Solutions
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When a claim has been paid, an EOB is sent to:



a. the clearinghouse.

b. the patient.

c. the provider.

d. the insurance company. - correct answer b. the patient.



Cost based fee schedules are developed using which of the following:



a. RBRVS methodology

b. total costs of every procedure o...
Which statement is TRUE regarding condition codes for the UB-04 claim form?

Selected Answer: d.



a. A condition code identified the department for the revenue of the procedure.

b. Condition codes are listed in the order of occurrence instead of numerical order.

c. Condition codes are reported o...
AAPC CPB - Chapter 8 Review Assisgnment Exam Questions Well Answered
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Which statement is TRUE regarding condition codes for the UB-04 claim form?

Selected Answer: d.



a. A condition code identified the department for the revenue of the procedure.

b. Condition codes are listed in the order of occurrence instead of numerical order.

c. Condition codes are reported o...
Prior authorization is reported in Item 23. What other information can be reported in this area of the CMS-1500 claim form?



a. Unlisted CPT® code(s)

b. mammography pre-certification number

c. patient identification number

d. patient account number - correct answer b. mammography pre-certifica...
AAPC CPB - Chapter 8 Quiz B Test Questions And Answers
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Prior authorization is reported in Item 23. What other information can be reported in this area of the CMS-1500 claim form?



a. Unlisted CPT® code(s)

b. mammography pre-certification number

c. patient identification number

d. patient account number - correct answer b. mammography pre-certifica...
Using the information in CPB Chapter 8 Case 1 to answer questions 1 and 2.

After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect?



I Date of birth

II Date of service

III Primary insurance policy number

IV Primary insurance group n...
AAPC CPB - Chapter 8 Practical Application Final Test With Complete Solutions
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Using the information in CPB Chapter 8 Case 1 to answer questions 1 and 2.

After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect?



I Date of birth

II Date of service

III Primary insurance policy number

IV Primary insurance group n...
MUE is the acronym for:



a. Medicare Unlikely Edits

b. Medically Unnecessary Edits

c. Medicare Unnecessary Edits

d. Medically Unlikely Edits - correct answer d. Medically Unlikely Edits



Based on NCCI edits, when a procedure is bundled and has a CCM indicator of 0 - which of the following Mod...
AAPC CPB - Chapter 7 Review Exam B With Correct Complete Solutions
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MUE is the acronym for:



a. Medicare Unlikely Edits

b. Medically Unnecessary Edits

c. Medicare Unnecessary Edits

d. Medically Unlikely Edits - correct answer d. Medically Unlikely Edits



Based on NCCI edits, when a procedure is bundled and has a CCM indicator of 0 - which of the following Mod...
A patient has a breast biopsy with placement of localization device (19083) with subsequent mastectomy (19301) at the same session after the biopsy is proven to be malignant. What modifier would be used for this scenario?



a. 59

b. 58

c. 25

d. 78 - correct answer b. 58



Medicare will consider...
AAPC CPB - Chapter 7 Quiz Test And Answers
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A patient has a breast biopsy with placement of localization device (19083) with subsequent mastectomy (19301) at the same session after the biopsy is proven to be malignant. What modifier would be used for this scenario?



a. 59

b. 58

c. 25

d. 78 - correct answer b. 58



Medicare will consider...
Use CPB Chapter 7_Case to answer questions 1 & 2.



A 40-year-old patient is trying Botox® for her chronic migraines. According to the policy, what are the symptom parameters that must be documented?



a. The patient has chronic migraines more than 15 days per month, with headaches lasting 4 hou...
AAPC CPB - Chapter 7 Practical Application Post Test And Answers Graded A+
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Use CPB Chapter 7_Case to answer questions 1 & 2.



A 40-year-old patient is trying Botox® for her chronic migraines. According to the policy, what are the symptom parameters that must be documented?



a. The patient has chronic migraines more than 15 days per month, with headaches lasting 4 hou...
A 65 year-old patient is seen in her physician's office with a laceration on her forehead. The cut is not deep for a suture repair. The physician decides to repair the wound with tissue adhesive. How would this be billed?



a. A4364

b. A4452

c. G0168

d. C1765 - correct answer c. G0168



What i...
AAPC CPB - Chapter 6 Review Study Guide Exam With Correct Answers
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A 65 year-old patient is seen in her physician's office with a laceration on her forehead. The cut is not deep for a suture repair. The physician decides to repair the wound with tissue adhesive. How would this be billed?



a. A4364

b. A4452

c. G0168

d. C1765 - correct answer c. G0168



What i...
A female patient is getting a right and left breast mastectomy bra with integrated form breast prosthesis. What HCPCS Level II code is reported?



a. L8002

b. L8002-50

c. L8001-50

d. L8000 - correct answer a. L8002



Patient is given 15 mg of methotrexate sodium IM for rheumatoid arthritis giv...
AAPC CPB - Chapter 6 Quiz
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A female patient is getting a right and left breast mastectomy bra with integrated form breast prosthesis. What HCPCS Level II code is reported?



a. L8002

b. L8002-50

c. L8001-50

d. L8000 - correct answer a. L8002



Patient is given 15 mg of methotrexate sodium IM for rheumatoid arthritis giv...
A patient is new to Medicare this year and sees his local family physician for his initial preventive physical for Medicare. What CPT or HCPCS Level II code is reported?



a. 99397

b. 99387

c. G0402

d. G0438 - correct answer c. G0402



What is the route of administration for the drug Vancomycin...
AAPC CPB - Chapter 6 Practical Application Test Well Answered
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A patient is new to Medicare this year and sees his local family physician for his initial preventive physical for Medicare. What CPT or HCPCS Level II code is reported?



a. 99397

b. 99387

c. G0402

d. G0438 - correct answer c. G0402



What is the route of administration for the drug Vancomycin...
Add-on Code - correct answer CPT code used to report a supplemental or additional procedure appended to a primary procedure (stand-alone) code. Add-on codes are recognized by the CPT symbol +used throughout the CPT code book



Centers for Medicare and Medicaid Services (CMS) - correct answer Agency...
AAPC CPB - Chapter 5 Terminology Practice Questions And Verified Answers
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Add-on Code - correct answer CPT code used to report a supplemental or additional procedure appended to a primary procedure (stand-alone) code. Add-on codes are recognized by the CPT symbol +used throughout the CPT code book



Centers for Medicare and Medicaid Services (CMS) - correct answer Agency...
Patient is seen for destruction of 2 skin lesions that were diagnosed as actinic keratosis (AK). Which of the following is the correct billing for removal of skin lesions?



a. 17000, 17003, 17004-59

b. 17000, 17003-51

c. 17000, 17003

d. 17004, 17003 - correct answer c. 17000, 17003



Sally is ...
AAPC CPB - Chapter 5 Review Test And Answers
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Patient is seen for destruction of 2 skin lesions that were diagnosed as actinic keratosis (AK). Which of the following is the correct billing for removal of skin lesions?



a. 17000, 17003, 17004-59

b. 17000, 17003-51

c. 17000, 17003

d. 17004, 17003 - correct answer c. 17000, 17003



Sally is ...
A 43-year-old established patient is seen for his annual preventive exam by the family physician. A comprehensive history, comprehensive exam, and medical decision making of low complexity is performed. What E/M code is reported?



a. 99215

b. 99396

c. 99386

d. 99402 - correct answer b. 99396


...
AAPC CPB - Chapter 5 Quiz Pro Final Exam And Answers
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A 43-year-old established patient is seen for his annual preventive exam by the family physician. A comprehensive history, comprehensive exam, and medical decision making of low complexity is performed. What E/M code is reported?



a. 99215

b. 99396

c. 99386

d. 99402 - correct answer b. 99396


...
A patient comes into the office for follow up of neck pain. The provider documents an expanded problem focused history, a problem focused exam and medical decision making of low complexity. What E/M code is reported for this visit?



a. 99212

b. 99213

c. 99202

d. 99201 - correct answer b. 99213
...
AAPC CPB - Chapter 5 Practical Application Actual Test With Verified Answers
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A patient comes into the office for follow up of neck pain. The provider documents an expanded problem focused history, a problem focused exam and medical decision making of low complexity. What E/M code is reported for this visit?



a. 99212

b. 99213

c. 99202

d. 99201 - correct answer b. 99213
...
What is/are the correct code(s) for a patient with acute on chronic maxillary sinusitis?



a. J01.00, J32.0

b. J01.00

c. J32.0, J01.00

d. J01.01 - correct answer a. J01.00, J32.0



Which sections of ICD-10-CM does a biller use to code for a physician's office?



a. ICD-10-CM Alphabetic Index...
AAPC CPB - Chapter 4 Quiz Final Exam Questions And Answers
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What is/are the correct code(s) for a patient with acute on chronic maxillary sinusitis?



a. J01.00, J32.0

b. J01.00

c. J32.0, J01.00

d. J01.01 - correct answer a. J01.00, J32.0



Which sections of ICD-10-CM does a biller use to code for a physician's office?



a. ICD-10-CM Alphabetic Index...
A patient was seen for a left ear infection. The provider diagnosed the patient with Swimmer's Ear in the left ear. The biller received a denial from XYZ Insurance Company stating H60.33 is an invalid diagnosis code. Why is this an invalid code?



a. H60.33 requires an additional character; the co...
AAPC CPB - Chapter 4 Practical Application Assessment Exam And Answers
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A patient was seen for a left ear infection. The provider diagnosed the patient with Swimmer's Ear in the left ear. The biller received a denial from XYZ Insurance Company stating H60.33 is an invalid diagnosis code. Why is this an invalid code?



a. H60.33 requires an additional character; the co...
What information can be released based on this Disclosure form?

AAPC Physician Practice are authorized to make the disclosure.



The type of information to be used or disclosed is as follows:

____ Problem list

____ Medication list

____ List of allergies

____ Immunization records

____ Most ...
AAPC CPB - Chapter 3 Review Exam And Answers
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What information can be released based on this Disclosure form?

AAPC Physician Practice are authorized to make the disclosure.



The type of information to be used or disclosed is as follows:

____ Problem list

____ Medication list

____ List of allergies

____ Immunization records

____ Most ...
Listed below are examples of patient reminders for appointments. Which one is HIPAA compliant?



a. "This is the obstetrical office calling to remind you of your appointment Tuesday, April 12 at 9 am for your annual exam."

b. "This is Dr. Smith's office calling to remind you of your appointmen...
AAPC CPB - Chapter 3 Quiz Assignment Test Questions Well Answered
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Listed below are examples of patient reminders for appointments. Which one is HIPAA compliant?



a. "This is the obstetrical office calling to remind you of your appointment Tuesday, April 12 at 9 am for your annual exam."

b. "This is Dr. Smith's office calling to remind you of your appointmen...
Which of the following does NOT qualify a patient for coverage under Medicare?



a. End Stage Renal Disease (ESRD)

b. Age 65 or older

c. Under age 65 with disabilities

d. Low income individual - correct answer d. Low income individual



The insurance claim process begins with:



a. Patient inf...
AAPC CPB - CHAPTER 3: QUESTIONS AND ANASWERS
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Which of the following does NOT qualify a patient for coverage under Medicare?



a. End Stage Renal Disease (ESRD)

b. Age 65 or older

c. Under age 65 with disabilities

d. Low income individual - correct answer d. Low income individual



The insurance claim process begins with:



a. Patient inf...
Use the CPB Chapter 3_Case to answer questions 1 & 2.



1. Susan smith arrives at her in-network primary care physician's office for her annual preventive visit. What is her copay?



a. $15.00

b. $50.00

c. $75.00

d. The patient does not have a copay for preventive visits. - correct answer d. ...
AAPC CPB - Chapter 3 Practical Application Exam With Correct Solutions
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Use the CPB Chapter 3_Case to answer questions 1 & 2.



1. Susan smith arrives at her in-network primary care physician's office for her annual preventive visit. What is her copay?



a. $15.00

b. $50.00

c. $75.00

d. The patient does not have a copay for preventive visits. - correct answer d. ...
Accountable Care Organization (ACO) - correct answer A healthcare organization characterized by a payment and care delivery model that seeks to tie provider reimbursements to quality metrics and reductions in the total cost of care for assigned population of patients



Capitation - correct answer F...
AAPC CPB - Chapter 2 Terminology Study Guide Exam Well Answred Rated A+
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Accountable Care Organization (ACO) - correct answer A healthcare organization characterized by a payment and care delivery model that seeks to tie provider reimbursements to quality metrics and reductions in the total cost of care for assigned population of patients



Capitation - correct answer F...
What is the largest health program in the United States?



a. Blue Cross Blue Shield

b. Medicare

c. Medicaid

d. TRICARE - correct answer b. Medicare



Which of the following services is NOT covered under Medicare Part B?



a. Cardiovascular disease screening

b. Diabetes self-management

c. Nu...
AAPC CPB - Chapter 2 Review Post Test With Verified Correct Answers
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What is the largest health program in the United States?



a. Blue Cross Blue Shield

b. Medicare

c. Medicaid

d. TRICARE - correct answer b. Medicare



Which of the following services is NOT covered under Medicare Part B?



a. Cardiovascular disease screening

b. Diabetes self-management

c. Nu...
A patient presents to be seen in the office. He does not pay at the time the services are rendered as the provider is his primary care provider, or gatekeeper. The large group practice has 800 covered members under this plan as is paid on a monthly basis with a set amount that is based on the number...
AAPC CPB - Chapter 2 Exam Quiz With Complete Solutions Graded A +
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A patient presents to be seen in the office. He does not pay at the time the services are rendered as the provider is his primary care provider, or gatekeeper. The large group practice has 800 covered members under this plan as is paid on a monthly basis with a set amount that is based on the number...
Why must a provider obtain an NPI number?

I. To submit claims

II. To prove that he is licensed

III. To be HIPAA compliant

IV. To guarantee payment by a health plan



a. I, II, III

b. II, III, IV

c. I, II, III, IV

d. I, III - correct answer d. I, III



A patient has receipts for her dental c...
AAPC CPB - CHAPTER 2: Test Questions With Quality Answers
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Why must a provider obtain an NPI number?

I. To submit claims

II. To prove that he is licensed

III. To be HIPAA compliant

IV. To guarantee payment by a health plan



a. I, II, III

b. II, III, IV

c. I, II, III, IV

d. I, III - correct answer d. I, III



A patient has receipts for her dental c...
What does the acronym PHI stand for?



a. Patient Healthcare Information

b. Patient History of Illness

c. Protected Health Information

d. Protected Healthcare Index - correct answer c. Protected Health Information



A new radiology company opens in town. The manager calls your practice and offe...
AAPC CPB - Chapter 1 Review Actual Test Questions And Answers Graded A+
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What does the acronym PHI stand for?



a. Patient Healthcare Information

b. Patient History of Illness

c. Protected Health Information

d. Protected Healthcare Index - correct answer c. Protected Health Information



A new radiology company opens in town. The manager calls your practice and offe...
Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction?



a. Payment and remittance advice

b. Eligibility in a health plan

c. Coordination of benefits

d. Physician unique identifier number - cor...
AAPC CPB - Chapter 1 Quiz Practice Test Questions With Verified Solutions
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Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction?



a. Payment and remittance advice

b. Eligibility in a health plan

c. Coordination of benefits

d. Physician unique identifier number - cor...
Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction?



a. Payment and remittance advice

b. Eligibility in a health plan

c. Coordination of benefits

d. Physician unique identifier number - cor...
AAPC CPB - CHAPTER 1:EXAM QUESTIONS WELL ANSWERED 100%
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Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction?



a. Payment and remittance advice

b. Eligibility in a health plan

c. Coordination of benefits

d. Physician unique identifier number - cor...
Use CPB Chapter 14_Case to answer questions 1 & 2.



After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect?



I. Insured's name

II. Secondary insurance

III. Primary insurance policy number

IV. Date of birth

V. Date of injury

VI...
AAPC Chapter 14 Practical Application Final Exam With Quality Complete Answers
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Use CPB Chapter 14_Case to answer questions 1 & 2.



After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect?



I. Insured's name

II. Secondary insurance

III. Primary insurance policy number

IV. Date of birth

V. Date of injury

VI...
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