AAPC CPB STUDY GUIDE 2027 ANSWERS AND
QUESTIONS SET A+
✔✔Services that are performed for treatment or diagnosis of an injury, illness, or
disease in accordance with generally accepted standards of medical practice defines: -
✔✔medical necessity
✔✔Codes that are considered to be bundled are based on Centers for Medicare &
Medicaid (CMS) standards called: - ✔✔NCCI
✔✔An E/M service that is performed during a post-operative period, but is not related to
the surgical procedure that was performed, can be billed with which modifier? - ✔✔24
✔✔Medicare provides a list of questions to ask beneficiaries that helps determine if
Medicare is primary or secondary. Where can this information be found? - ✔✔MSP
Manual
✔✔What type of code reports the event(s) related to the billing period on the UB-04
claim form? - ✔✔occurrence codes
✔✔What is the purpose of the standard CMS-1500 claim form? - ✔✔pro services for
phys
✔✔FL 35 and FL 36 are used on the UB-04 claim form to identify occurrence span code
and dates. When is this section completed? - ✔✔inpt services
✔✔When entering the patient's name on the CMS-1500 claim form, what punctuation
should be used? - ✔✔comma
✔✔A ___ is used to indicate an inpatient service is reported on an outpatient claim. -
✔✔condition code
, ✔✔The UB-04 claim form is also called: - ✔✔CMS 1450
✔✔Determination of the insurer's payment amount after the member's insurance
benefits have been applied. - ✔✔adjudication
✔✔___ provider with overall responsibility for the patient's medical care during
hospitalization. - ✔✔attending
✔✔Identify the correct format to enter the date of birth on a paper CMS-1500 claim form
- ✔✔MMDDCCYY
✔✔On the UB-04 claim form, the type of bill is identified by a four-digit numerical code.
The first digit is a leading zero, what does the second digit represent? - ✔✔facility type
✔✔Medicare refers to the insured's ID as the: - ✔✔health ins claim number
✔✔The provider accepts a contractual write-off of the difference between the charged
amount and the allowed amount. - ✔✔accepting assignment
✔✔Which regulation established claim standards for electronic filing requirements when
a provider uses a computer with software to submit an electronic claim? - ✔✔HIPAA
✔✔Which is NOT used for data entry? - ✔✔intl audit sys
✔✔________ is when the provider has limited access to payer and patient data
elements on their patients only. - ✔✔extranet
✔✔When a batch of claims is submitted electronically to a clearinghouse a report is
sent to the provider. Which feedback does this report from the clearinghouse identify? -
✔✔claims sent to payer/rejected
✔✔A hospital chargemaster does NOT contain which of the following? - ✔✔ICD10CM
codes
✔✔Which of the following documentation is NOT needed for an audit? - ✔✔EOB
✔✔Payments due from patients, payers, or other guarantors that are owed to the
practice for services rendered are considered - ✔✔Accounts Receivable
✔✔sent by payers to identify the status of a claim and indicate if that claim has been
accepted, adjudicated, and/or received by the payer. - ✔✔status reports
QUESTIONS SET A+
✔✔Services that are performed for treatment or diagnosis of an injury, illness, or
disease in accordance with generally accepted standards of medical practice defines: -
✔✔medical necessity
✔✔Codes that are considered to be bundled are based on Centers for Medicare &
Medicaid (CMS) standards called: - ✔✔NCCI
✔✔An E/M service that is performed during a post-operative period, but is not related to
the surgical procedure that was performed, can be billed with which modifier? - ✔✔24
✔✔Medicare provides a list of questions to ask beneficiaries that helps determine if
Medicare is primary or secondary. Where can this information be found? - ✔✔MSP
Manual
✔✔What type of code reports the event(s) related to the billing period on the UB-04
claim form? - ✔✔occurrence codes
✔✔What is the purpose of the standard CMS-1500 claim form? - ✔✔pro services for
phys
✔✔FL 35 and FL 36 are used on the UB-04 claim form to identify occurrence span code
and dates. When is this section completed? - ✔✔inpt services
✔✔When entering the patient's name on the CMS-1500 claim form, what punctuation
should be used? - ✔✔comma
✔✔A ___ is used to indicate an inpatient service is reported on an outpatient claim. -
✔✔condition code
, ✔✔The UB-04 claim form is also called: - ✔✔CMS 1450
✔✔Determination of the insurer's payment amount after the member's insurance
benefits have been applied. - ✔✔adjudication
✔✔___ provider with overall responsibility for the patient's medical care during
hospitalization. - ✔✔attending
✔✔Identify the correct format to enter the date of birth on a paper CMS-1500 claim form
- ✔✔MMDDCCYY
✔✔On the UB-04 claim form, the type of bill is identified by a four-digit numerical code.
The first digit is a leading zero, what does the second digit represent? - ✔✔facility type
✔✔Medicare refers to the insured's ID as the: - ✔✔health ins claim number
✔✔The provider accepts a contractual write-off of the difference between the charged
amount and the allowed amount. - ✔✔accepting assignment
✔✔Which regulation established claim standards for electronic filing requirements when
a provider uses a computer with software to submit an electronic claim? - ✔✔HIPAA
✔✔Which is NOT used for data entry? - ✔✔intl audit sys
✔✔________ is when the provider has limited access to payer and patient data
elements on their patients only. - ✔✔extranet
✔✔When a batch of claims is submitted electronically to a clearinghouse a report is
sent to the provider. Which feedback does this report from the clearinghouse identify? -
✔✔claims sent to payer/rejected
✔✔A hospital chargemaster does NOT contain which of the following? - ✔✔ICD10CM
codes
✔✔Which of the following documentation is NOT needed for an audit? - ✔✔EOB
✔✔Payments due from patients, payers, or other guarantors that are owed to the
practice for services rendered are considered - ✔✔Accounts Receivable
✔✔sent by payers to identify the status of a claim and indicate if that claim has been
accepted, adjudicated, and/or received by the payer. - ✔✔status reports
