Mock CPB Exam Practice Questions and Answers

Mock CPB Exam Practice Questions and Answers Court decisions that establish a standard use legal decisions to serve as authoritative rules or patterns in future similar cases. The legal term for standard is ______. a. decision b. example c. precedent d. statute - ANSWER-precedent Which is established in advance and based on reported health care charges from which a predetermined per diem rate is determined? a. prospective cost-based rate b. retrospective reasonable cost system c. prospective price-based rate d. site-of-service differential - ANSWER-prospective cost-based rate ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/82 Which is a legal action that can be used to recover a debt and is usually a last resort for a medical practice? a. litigation b. mediation c. adjudication d. subrogation - ANSWER-litigation When a child lives with both parents, and each parent subscribes to a different health insurance plan, the primary and secondary policies are determined by applying the birthday rule. The individual who holds the primary policy for dependent children is the spouse whose birth ______. a. month and day occur earlier in the calendar year b. year occurs earlier c. day occurs earlier in the month d. month, day, and year occur earlier - ANSWER-month and day occur earlier in the calendar year TRICARE deductibles are applied to the government's ______ year, which runs from October 1 of one year to September 30 of the next. a. fiscal ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/82 b. calendar c. consecutive d. sequential - ANSWER-fiscal The Resource Based Relative Value Scale (RBRVS) system reimburses physicians' practice expenses using a ______. a. usual and reasonable payment basis b. prospective payment system c. guaranteed issue method d. fee schedule - ANSWER-fee schedule OSHA has special significance for those employed in health care because employers are required to obtain and retain manufacturers' Material Safety Data Sheets (MSDS), which contain information about ______ used on site. Training employees in the safe handling of these substances is also required. a. vaccinations and drugs b. possibly harmful agents only c. oral, IM, and IV medications ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/82 d. chemical and hazardous substances - ANSWER-chemical and hazardous substances The BCBS PPO plan is sometimes described as a subscriber-driven program, and BCBS substitutes the term subscriber or ______ for policyholder. a. payer b. provider c. patient d. member - ANSWER-member Which type of automobile insurance pays for damage to a covered vehicle caused by hitting an object or being hit during an automobile accident? a. liability b. collision c. personal injury protection d. comprehensive - ANSWER-collision BlueShield plans were created as the result of a resolution passed by the House of Delegates at an American Medical Association meeting in 1938. This resolution supported the concept of ______ health insurance that would encourage physicians to cooperate with prepaid health care plans. ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 5/82 a. voluntary b. mandatory c. commercial d. profit - ANSWER-voluntary Which of the following is an example of abuse? a. submitting claims for services and procedures knowingly not provided b. misrepresenting ICD-10-CM and CPT/HCPCS codes to justify payment c. billing noncovered services/procedures as covered services/procedures d. falsifying health care certificates of medical necessity plans of treatment - ANSWER-billing noncovered services/procedures as covered services/procedures Which code represents a new patient exam in which the physician documents a detailed history, detailed examination, and medical decision making of low complexity? a. 99203 b. 99204 c. 99214 ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 6/82 d. 99213 - ANSWER-99203 Which punctuation is used in the ICD-10-CM index to identify manifestation codes and in the ICD-10-CM index and tabular list to enclose abbreviations, synonyms, alternative wording, or explanatory phrases? a. braces b. parentheses c. colons d. slanted brackets - ANSWER-slanted brackets