CPB Ch. 8 Practical Application
questions well answered 2025/2026
Use CPB Chapter 8_Case 1.pdf 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 number
V. Secondary insurance policy number
VI. Secondary insurance group number
VII. Place of service
VIII. Diagnosis code
IX. Provider signature
X. Work related - correct answer ✔✔I, VIII, and X
Rationale: The date of birth is not in the correct format and the birth year is incorrect. The date
of birth is shown as Item 3 on the claim form. Enter the patient's 8-digit birth date (MM|DD|
CCYY). The diagnosis code is a truncated (incomplete) code. Look in the ICD-10-CM code book
for S23.3; a 7th character is required. Two placeholder Xs are placed in the 5th and 6th positions
to keep the 7th character in the 7th position. Box 10 indicates this is employment related but
the demographic information indicates it is not work related.
What should be done to correct the claim?
I. Correct the formatting of Item 3 on the claim.
II. Add the patient's secondary insurance information on the claim.
, III. Enter the ordering provider's name and NPI.
IV. Review the ICD-10-CM codebook and the medical record to determine the correct diagnosis
code.
V. Correct Item 10 to No for Employment. - correct answer ✔✔I, IV, and V
Rationale: Item 3 needs to be formatted to include a zero before the month and the day so the
format of the date of birth is correct and change the year to 1973 instead of 1963. Because the
ICD-10-CM code is truncated, the biller will need to view the code book to determine how many
characters are needed and medical records is to complete applying those characters. Item 10
should be marked as No for Employment related.
Using the information in CPB Chapter 8_Case 2.pdf to answer question 3.
After review of the information provided, are there any errors on the claim form? If so, which
elements are incorrect?
I. Primary Insurance
II. Primary insurance ID number
III. Relationship to the insured
IV. Place of service
V. Provider NPI
VI. CPT code(s)
VII. Diagnosis code
VIII. Units of service
IX. Service Facility Location Information - correct answer ✔✔III and VII
Rationale: All elements of the claim are correct except: III - relationship to the insured is
incorrect. Spouse is checked, where self needs to be checked. VII - the diagnosis code needs
another character. When the code is referenced in the Tabular List, a 7th character icon
indicates the need for a 7th character. The A for initial visit is added to the end of the code.
questions well answered 2025/2026
Use CPB Chapter 8_Case 1.pdf 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 number
V. Secondary insurance policy number
VI. Secondary insurance group number
VII. Place of service
VIII. Diagnosis code
IX. Provider signature
X. Work related - correct answer ✔✔I, VIII, and X
Rationale: The date of birth is not in the correct format and the birth year is incorrect. The date
of birth is shown as Item 3 on the claim form. Enter the patient's 8-digit birth date (MM|DD|
CCYY). The diagnosis code is a truncated (incomplete) code. Look in the ICD-10-CM code book
for S23.3; a 7th character is required. Two placeholder Xs are placed in the 5th and 6th positions
to keep the 7th character in the 7th position. Box 10 indicates this is employment related but
the demographic information indicates it is not work related.
What should be done to correct the claim?
I. Correct the formatting of Item 3 on the claim.
II. Add the patient's secondary insurance information on the claim.
, III. Enter the ordering provider's name and NPI.
IV. Review the ICD-10-CM codebook and the medical record to determine the correct diagnosis
code.
V. Correct Item 10 to No for Employment. - correct answer ✔✔I, IV, and V
Rationale: Item 3 needs to be formatted to include a zero before the month and the day so the
format of the date of birth is correct and change the year to 1973 instead of 1963. Because the
ICD-10-CM code is truncated, the biller will need to view the code book to determine how many
characters are needed and medical records is to complete applying those characters. Item 10
should be marked as No for Employment related.
Using the information in CPB Chapter 8_Case 2.pdf to answer question 3.
After review of the information provided, are there any errors on the claim form? If so, which
elements are incorrect?
I. Primary Insurance
II. Primary insurance ID number
III. Relationship to the insured
IV. Place of service
V. Provider NPI
VI. CPT code(s)
VII. Diagnosis code
VIII. Units of service
IX. Service Facility Location Information - correct answer ✔✔III and VII
Rationale: All elements of the claim are correct except: III - relationship to the insured is
incorrect. Spouse is checked, where self needs to be checked. VII - the diagnosis code needs
another character. When the code is referenced in the Tabular List, a 7th character icon
indicates the need for a 7th character. The A for initial visit is added to the end of the code.
