©BRIGHTSTARS EXAM SOLUTIONS
10/21/2024 9:24 PM
Practice Examination – CPB Questions And
Answers 100% Pass.
Who is covered by CHAMPVA? - answer✔Veterans with service-connected disabilities and
their families.
Patient is brought to the local urgent care after falling from a ladder while hanging exterior lights
on his house. X-rays revealed a closed fracture of his left femur. The patient is covered by his
employer's group health plan, and he also has a homeowner's liability insurance policy. Which
insurance should be billed? - answer✔The employer's group health plan.
Which do private companies contract with CMS to administer? - answer✔Medicare Part A, B, &
C
What is a co-payment? - answer✔A flat amount paid to the heathcare provider when the
policyholder is seen for an office vist.
Which of the following statements is true regarding the non-PAR Medicare allowed fee
schedule? - answer✔The non-PAR limiting charge is 115% of the non-PAR Medicare Physician
Fee Schedule.
What is Medigap policy? - answer✔A policy that covers healthcare services that Medicare does
not cover.
Medicare Part A is available to individuals under the age of 65 who have which of the
following? - answer✔End-stage renal disease (ESRD) and meet certain requirements.
Which of the following statements is true regarding Medicaid? - answer✔Medicaid programs
receive matching federal funding only if certain healthcare services are provided to eligible
individuals.
When submitting a Medigap policy, which option is an example of how the patient's ID number
should appear in item 9a of the CMS-1500 claim form? - answer✔MGAP 124356789
Medicaid covers EPSDT services. What is the definition of this acronym? - answer✔Early and
Periodic Screening, Diagnostic, and Treatment
, ©BRIGHTSTARS EXAM SOLUTIONS
10/21/2024 9:24 PM
A Medicare patient has been treated for four (4) diagnoses during his last visit: hypertension,
type 2 diabetes, osteoarthritis, and CKD. How many diagnoses can be reported in Box 24E
(Diagnosis Code Pointer) CMS-1500 claim form for each service provided for this patient? -
answer✔One
To compare units of service with CPT and HCPCS Level II codes, CMS added which of the
following to the NCCI program? - answer✔Medically unlikely edits
Which of the following scenarios would support billing incident-to-services? - answer✔An
established patient seen by a mid-level provider for follow-up for blood pressure check,
physician is in the office suite.
What is linked by NCD's and LCD's? - answer✔Diagnoses to procedures or service that are
determined to be reasonable and medically necessary for Medicare patients.
CPT codes 64418 and 19380 were reported together for the injection of the supra capsular nerve
with anesthetic agent (64418) with revision of a reconstructed breast (19380). The injection was
denied as a bundled service. What is the next step for the biller? - answer✔Write off the charge
for 64418 because it is a bundled procedure.
By signing the Assignment of Benefits in item 13 of the CMS-1500 claim form, what is the
patient doing? - answer✔Directing the insurance company to send the reimbursement to the
provider.
What form is revenue code that indicates the type or location of service reported on? -
answer✔UB-40 claim form
Which of the following statements is NOT true for the TOB codes? - answer✔Digit 1 identifies
the type of facility.
The following types of charges would be reported on the CMS-1500 claim form EXCEPT
which? - answer✔Room and board
How long do Medicare Conditions of Participation (CoP) require that medical records be
retained for? - answer✔5 years
The Health Insurance Portability and Accountability Act (HIPAA) defines abuse as which of the
following? - answer✔Actions not consistent with accepted and sound medical, business, or fiscal
practices.
How often should authorization forms be updated for established patients who are seen on a
regular basis? - answer✔Once a year
10/21/2024 9:24 PM
Practice Examination – CPB Questions And
Answers 100% Pass.
Who is covered by CHAMPVA? - answer✔Veterans with service-connected disabilities and
their families.
Patient is brought to the local urgent care after falling from a ladder while hanging exterior lights
on his house. X-rays revealed a closed fracture of his left femur. The patient is covered by his
employer's group health plan, and he also has a homeowner's liability insurance policy. Which
insurance should be billed? - answer✔The employer's group health plan.
Which do private companies contract with CMS to administer? - answer✔Medicare Part A, B, &
C
What is a co-payment? - answer✔A flat amount paid to the heathcare provider when the
policyholder is seen for an office vist.
Which of the following statements is true regarding the non-PAR Medicare allowed fee
schedule? - answer✔The non-PAR limiting charge is 115% of the non-PAR Medicare Physician
Fee Schedule.
What is Medigap policy? - answer✔A policy that covers healthcare services that Medicare does
not cover.
Medicare Part A is available to individuals under the age of 65 who have which of the
following? - answer✔End-stage renal disease (ESRD) and meet certain requirements.
Which of the following statements is true regarding Medicaid? - answer✔Medicaid programs
receive matching federal funding only if certain healthcare services are provided to eligible
individuals.
When submitting a Medigap policy, which option is an example of how the patient's ID number
should appear in item 9a of the CMS-1500 claim form? - answer✔MGAP 124356789
Medicaid covers EPSDT services. What is the definition of this acronym? - answer✔Early and
Periodic Screening, Diagnostic, and Treatment
, ©BRIGHTSTARS EXAM SOLUTIONS
10/21/2024 9:24 PM
A Medicare patient has been treated for four (4) diagnoses during his last visit: hypertension,
type 2 diabetes, osteoarthritis, and CKD. How many diagnoses can be reported in Box 24E
(Diagnosis Code Pointer) CMS-1500 claim form for each service provided for this patient? -
answer✔One
To compare units of service with CPT and HCPCS Level II codes, CMS added which of the
following to the NCCI program? - answer✔Medically unlikely edits
Which of the following scenarios would support billing incident-to-services? - answer✔An
established patient seen by a mid-level provider for follow-up for blood pressure check,
physician is in the office suite.
What is linked by NCD's and LCD's? - answer✔Diagnoses to procedures or service that are
determined to be reasonable and medically necessary for Medicare patients.
CPT codes 64418 and 19380 were reported together for the injection of the supra capsular nerve
with anesthetic agent (64418) with revision of a reconstructed breast (19380). The injection was
denied as a bundled service. What is the next step for the biller? - answer✔Write off the charge
for 64418 because it is a bundled procedure.
By signing the Assignment of Benefits in item 13 of the CMS-1500 claim form, what is the
patient doing? - answer✔Directing the insurance company to send the reimbursement to the
provider.
What form is revenue code that indicates the type or location of service reported on? -
answer✔UB-40 claim form
Which of the following statements is NOT true for the TOB codes? - answer✔Digit 1 identifies
the type of facility.
The following types of charges would be reported on the CMS-1500 claim form EXCEPT
which? - answer✔Room and board
How long do Medicare Conditions of Participation (CoP) require that medical records be
retained for? - answer✔5 years
The Health Insurance Portability and Accountability Act (HIPAA) defines abuse as which of the
following? - answer✔Actions not consistent with accepted and sound medical, business, or fiscal
practices.
How often should authorization forms be updated for established patients who are seen on a
regular basis? - answer✔Once a year
