AAPC CPB - Chapter 7 Practical Application Exam Practice Questions and Answers

AAPC CPB - Chapter 7 Practical Application Exam Practice Questions and Answers 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 hours a day or longer. b. There are not specific documentation requirements for the use of Botox® for chronic migraines. c. The patient has chronic intractable migraines with status migrainosus. d. A diagnosis of chronic migraines is sufficient. - Answer️️ -a. The patient has chronic migraines more than 15 days per month, with headaches lasting 4 hours a day or longer. ©SOPHIABENNET@ Thursday, August 22, 2024 10:21 AM Certified Professional Biller By: American Academy of Professional Coders(AAPC) 2 Rationale: When Botox® (onabotulinumtoxina) is used for the FDA approved indication of prophylaxis of headaches in adult patients with chronic migraine (> 15 days per month with headache lasting 4 hours a day or longer), the documentation must support these specific symptom parameters. Use CPB Chapter 7_Case to answer the following question. The patient has had three injections without relief from the migraines. According to the policy in Chapter 7 Case 1 pdf, what will be considered for coverage by Medicare? a. All three injections will be covered by Medicare. b. Two of the three injections are covered when the treatment fails. c. Only one injection is covered by Medicare. d. None of the injections are covered as Botox® is not a covered condition for chronic migraines. - Answer️️ -b. Two of the three injections are covered when the treatment fails. ©SOPHIABENNET@ Thursday, August 22, 2024 10:21 AM Certified Professional Biller By: American Academy of Professional Coders(AAPC) 3 Rationale: According to the policy above, it is expected that patients will not continue to receive injections of Botox® if, after 2 consecutive injections, using maximum dose for the size of the muscle, treatment has failed. A 40-year-old patient has severe pain in his lower back. After multiple surgeries, physical therapy, and various medications without relief, the provider performed percutaneous epidural lysis of adhesions. An epidural catheter is placed and an epidurography is performed. A series of injections are performed over a span of 3 days. The catheter is removed. Utilize the NCCI edits and MUE edits above. Which of the following is the correct way to report this procedure? :a. 62264 b. 62264 x 2 c. 62263 d. 62263, 62264 - Answer️️ -c. 62263 Rationale: The procedure occurred over a three-day period. According to the NCCI edits, 62263 and 62264 cannot be reported together due to the description of the codes. According to the MUE edits, 62263