AAPC CPB - Chapter 8 Practical Application
Using the information in CPB Chapter 8 Case 1 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 Billing provider
IX Provider signature
X Work related
a. I, III, VII, and IX
b. I and X
c. V, VII, and VI
d. There are no errors on this claim. - correct answer b. I 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 in Item 3 on the claim form. Enter the patient's 8-digit birth date (MM|DD|CCYY). The claim form states the injury is work related however based on the documentation this injury was not due to work.
Using the information in CPB Chapter 8 Case 1, answer the following question. 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 Review the medical record to verify an X-Ray was performed.
a. II and V
b. I, II, and III
c. I and IV
d. There are no errors on this claim. - correct answer c. I and IV
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 codebook to determine how many characters are needed and medical record is required to complete applying those characters.
Using the information in CPB Chapter 8 Case 2 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 Modifier
VIII Diagnosis code
Using the information in CPB Chapter 8 Case 1 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 Billing provider
IX Provider signature
X Work related
a. I, III, VII, and IX
b. I and X
c. V, VII, and VI
d. There are no errors on this claim. - correct answer b. I 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 in Item 3 on the claim form. Enter the patient's 8-digit birth date (MM|DD|CCYY). The claim form states the injury is work related however based on the documentation this injury was not due to work.
Using the information in CPB Chapter 8 Case 1, answer the following question. 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 Review the medical record to verify an X-Ray was performed.
a. II and V
b. I, II, and III
c. I and IV
d. There are no errors on this claim. - correct answer c. I and IV
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 codebook to determine how many characters are needed and medical record is required to complete applying those characters.
Using the information in CPB Chapter 8 Case 2 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 Modifier
VIII Diagnosis code
