QUESTIONS AND VERIFIED CORRECT ANSWERS 2025-2026 ||
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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
IX Units of service
X Service Facility Location Information
a. III, IV, and X
b. III and VIII
c. VIII, IV and X
d. None of the above - CORRECT ANSWER- b. III and VIII
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. VIII - the diagnosis code needs