PRACTICAL APPLICATION
ANSWER ALL QUESTIONS IN THIS SECTION
QUESTION 1
Using the information in CPB Chapter 8 Case 4 to answer question 5.
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 Birthdate of insured
V Provider NPI
VI CPT code(s)
VII Modifier
VIII Diagnosis code
IX Units of service
X Service Facility Location Information
a. I, IV, V and VIII
b. II, V, and VI
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, AAPC CPB - CHAPTER 8 2025
PRACTICAL APPLICATION
c. II and V
d. None of the above - ANSWERS-a. I, IV, V and VIII
Rationale: All of the elements are correct except -I - Primary Insurance. The
primary insurance listed on the claim is Medhealth. It should be Health Systems.
IV - There is no secondary insurance listed on the claim form. V - Secondary
insurance ID number. Because there is no secondary insurance listed, there is also
no insurance ID listed. VIII - Diagnosis code(s). The diagnosis code is incorrect.
Enter the ICD-10-CM codes without decimals in proper code sequence. For
example, code F17.219 should be reported as F17219 on the claim form
QUESTION 2
Use the information in CPB Chapter 8 Case 5 to answer questions 6 and 7. 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 Secondary insurance policy
V Secondary insurance policy number
VI Secondary insurance group number
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