AAPC CPB Practice Actual Exam Questions
And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf.
Ms. Robinson is seen by Dr. Judy on 4/13/17. The claim is sent to Medicare for
payment on 4/12/18. Which of the following statements is correct?
A. Medicare will deny the claim based on the timely filing statute.
B. Medicare will reimburse the claim at 80% of the charges billed.
C. Medicare will pass on the claim to the secondary insurance.
D. Medicare will pay the claim for the services provided based on the timely filing
statute ☑️ANSWER☑️D. Medicare will pay the claim for the services provided
based on the timely filing statute
Mr. Wilson was putting up a fence at his friend's house. In the process of nailing
the fence to the posts, a nail was pushed through his thumb. His friend has
homeowner's liability insurance and the patient has commercial coverage through
his employer. Which of the following is correct?
A. File the homeowner's liability as the primary payer and the commercial carrier
as the secondary carrier if the primary denies the claim.
B. File the homeowner's liability only
C. File the commercial insurance only.
,D. File the commercial insurance carrier as the primary payer and the
homeowner's carrier as the secondary carrier if the primary denies the claim
☑️ANSWER☑️A. File the homeowner's liability as the primary payer and the
commercial carrier as the secondary carrier if the primary denies the claim.
What resources could a biller use to determine whether a procedure is bundled
with another procedure according to Medicare?
I Star icon
II. CPT® section guidelines
III. Parenthetical instructions in the CPT® codebook
IV. NCCI edits
V. RVU file
A. I, IV, and V
B. II, III, and IV
C. IV only
D. II only ☑️ANSWER☑️B. II, III, and IV
Which statement is TRUE regarding appeals?
A. An appeal should be written if a claim is denied by the payer in error.
B. An appeal should be completed for all denials.
C. Timely filing claims cannot be appealed.
D. All insurance carriers have the same standard for appeals. ☑️ANSWER☑️A. An
appeal should be written if a claim is denied by the payer in error.
,A patient has a major surgery on her hip on January 3. Two weeks later, the same
patient is seen by the provider for migraines. How would the office visit be
reported?
A. Modifier 59 is appended to the office visit to identify it is a distinct visit from
the surgical procedure.
B. The office visit is reported without a modifier as this is outside of the global
period for a major surgical procedure.
C. Modifier 24 is appended to the office visit to indicate it is unrelated to the
surgical procedure.
D. The office visit is not reported as it is considered inclusive to the major surgical
procedure. ☑️ANSWER☑️C. Modifier 24 is appended to the office visit to indicate
it is unrelated to the surgical procedure.
A Medicare patient has bilateral open treatment of iliac wing fracture patterns
that do not disrupt the pelvic ring. How is this service reported?
A. 27215
B. G0412
C. 27215-50
D. G0412-50 ☑️ANSWER☑️B. G0412
A 12-month-old established patient is coming in to see the pediatrician for an
annual physical exam. The physician decides to administer the Hib-HepB vaccine
intramuscularly. Counseling was provided by the physician to the mother about
each vaccine. What codes are reported for this encounter?
, A. 99392-25, 90460, 90461, 90748
B. 99391-25, 90460 x 2, 90748
C. 99382-25, 90460 x 2, 90743, 90648
D. 99391-25, 90460, 90461, 90748 ☑️ANSWER☑️A. 99392-25, 90460, 90461,
90748
Patient had an open cholecystectomy three weeks ago. During the postoperative
period the patient comes in to see his doctor (who performed the
cholecystectomy) for a sore throat and productive cough. The physician performs
a problem focused history, expanded problem focused exam, and medical
decision of low complexity. The patient has an upper respiratory infection. How is
this reported?
A. 99213-55
B. 99213-78
C. 99213-24
D. 99213-26 ☑️ANSWER☑️C. 99213-24
A 54-year-old male presents to his family physician with dizziness. During the
physical exam his blood pressure is 200/130. After a complete work-up, including
laboratory tests, the physician makes a diagnosis of stage V kidney disease due to
malignant hypertension. What is the appropriate diagnosis code(s) for this
encounter?
A. I12.0, N18.5
B. I12.0, N18.6
C. N18.5, I12.0
And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf.
Ms. Robinson is seen by Dr. Judy on 4/13/17. The claim is sent to Medicare for
payment on 4/12/18. Which of the following statements is correct?
A. Medicare will deny the claim based on the timely filing statute.
B. Medicare will reimburse the claim at 80% of the charges billed.
C. Medicare will pass on the claim to the secondary insurance.
D. Medicare will pay the claim for the services provided based on the timely filing
statute ☑️ANSWER☑️D. Medicare will pay the claim for the services provided
based on the timely filing statute
Mr. Wilson was putting up a fence at his friend's house. In the process of nailing
the fence to the posts, a nail was pushed through his thumb. His friend has
homeowner's liability insurance and the patient has commercial coverage through
his employer. Which of the following is correct?
A. File the homeowner's liability as the primary payer and the commercial carrier
as the secondary carrier if the primary denies the claim.
B. File the homeowner's liability only
C. File the commercial insurance only.
,D. File the commercial insurance carrier as the primary payer and the
homeowner's carrier as the secondary carrier if the primary denies the claim
☑️ANSWER☑️A. File the homeowner's liability as the primary payer and the
commercial carrier as the secondary carrier if the primary denies the claim.
What resources could a biller use to determine whether a procedure is bundled
with another procedure according to Medicare?
I Star icon
II. CPT® section guidelines
III. Parenthetical instructions in the CPT® codebook
IV. NCCI edits
V. RVU file
A. I, IV, and V
B. II, III, and IV
C. IV only
D. II only ☑️ANSWER☑️B. II, III, and IV
Which statement is TRUE regarding appeals?
A. An appeal should be written if a claim is denied by the payer in error.
B. An appeal should be completed for all denials.
C. Timely filing claims cannot be appealed.
D. All insurance carriers have the same standard for appeals. ☑️ANSWER☑️A. An
appeal should be written if a claim is denied by the payer in error.
,A patient has a major surgery on her hip on January 3. Two weeks later, the same
patient is seen by the provider for migraines. How would the office visit be
reported?
A. Modifier 59 is appended to the office visit to identify it is a distinct visit from
the surgical procedure.
B. The office visit is reported without a modifier as this is outside of the global
period for a major surgical procedure.
C. Modifier 24 is appended to the office visit to indicate it is unrelated to the
surgical procedure.
D. The office visit is not reported as it is considered inclusive to the major surgical
procedure. ☑️ANSWER☑️C. Modifier 24 is appended to the office visit to indicate
it is unrelated to the surgical procedure.
A Medicare patient has bilateral open treatment of iliac wing fracture patterns
that do not disrupt the pelvic ring. How is this service reported?
A. 27215
B. G0412
C. 27215-50
D. G0412-50 ☑️ANSWER☑️B. G0412
A 12-month-old established patient is coming in to see the pediatrician for an
annual physical exam. The physician decides to administer the Hib-HepB vaccine
intramuscularly. Counseling was provided by the physician to the mother about
each vaccine. What codes are reported for this encounter?
, A. 99392-25, 90460, 90461, 90748
B. 99391-25, 90460 x 2, 90748
C. 99382-25, 90460 x 2, 90743, 90648
D. 99391-25, 90460, 90461, 90748 ☑️ANSWER☑️A. 99392-25, 90460, 90461,
90748
Patient had an open cholecystectomy three weeks ago. During the postoperative
period the patient comes in to see his doctor (who performed the
cholecystectomy) for a sore throat and productive cough. The physician performs
a problem focused history, expanded problem focused exam, and medical
decision of low complexity. The patient has an upper respiratory infection. How is
this reported?
A. 99213-55
B. 99213-78
C. 99213-24
D. 99213-26 ☑️ANSWER☑️C. 99213-24
A 54-year-old male presents to his family physician with dizziness. During the
physical exam his blood pressure is 200/130. After a complete work-up, including
laboratory tests, the physician makes a diagnosis of stage V kidney disease due to
malignant hypertension. What is the appropriate diagnosis code(s) for this
encounter?
A. I12.0, N18.5
B. I12.0, N18.6
C. N18.5, I12.0
