- Study guides, Class notes & Summaries

AAPC CPB - Chapter 4 Practical Application Study Questions 2024.A patient was seen for a left ear infection. The provider diagnosed the patient with Swimmer's Ear in the left ear. The biller received a denial from XYZ Insurance Company stating H60.33 is an invalid diagnosis code. Why is this an invalid code? a. H60.33 requires an additional character; the code should be H60.332 b. H60.33 requires an additional character; the code should be H60.339 c. H60.33 is not an invalid diagnosis ...

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3 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 4 Quiz Correctly Answered 2024. What is/are the correct code(s) for a patient with acute on chronic maxillary sinusitis? a. J01.00, J32.0 b. J01.00 c. J32.0, J01.00 d. J01.01 - correct answer a. J01.00, J32.0 Which sections of ICD-10-CM does a biller use to code for a physician's office? a. ICD-10-CM Alphabetic Index and Tabular List b. Alphabetic Index only c. Tabular List only d. ICD-10-CM and ICD-10-PCS - correct answer a. ICD-10-CM Alphabetic Index and...

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4 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 4 Review Test Guide Quiz 2024.What is the ICD-10-CM code for a sore throat? a. J02.8 b. J02.0 c. J02.9 d. J31.2 - correct answer c. J02.9 Patient is diagnosed with right bundle branch block. What ICD-10-CM code is reported? a. I45.10 b. I45.19 c. I45.5 d. I45.9 - correct answer a. I45.10 Patient is diagnosed with a pressure ulcer of the heel. What ICD-10-CM code is reported? a. L89.601 b. L89.6 c. L89.609 d. L89.600 - correct answer c. L89.609 A pati...

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7 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 5 Review Questions Correctly Answered 2024. Patient is seen for destruction of 2 skin lesions that were diagnosed as actinic keratosis (AK). Which of the following is the correct billing for removal of skin lesions? a. 17000, 17003, 17004-59 b. 17000, 17003-51 c. 17000, 17003 d. 17004, 17003 - correct answer c. 17000, 17003 Sally is a 45-year-old female, established patient seen for an annual gynecological exam. The physician performs a comprehensive history and a de...

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8 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 5 Terminology Advanced Test 2024. Add-on Code - correct answer CPT code used to report a supplemental or additional procedure appended to a primary procedure (stand-alone) code. Add-on codes are recognized by the CPT symbol +used throughout the CPT code book Centers for Medicare and Medicaid Services (CMS) - correct answer Agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state ...

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2 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 6 Practical Application Questions Guide 2024.A patient is new to Medicare this year and sees his local family physician for his initial preventive physical for Medicare. What CPT or HCPCS Level II code is reported? a. 99397 b. 99387 c. G0402 d. G0438 - correct answer c. G0402 What is the route of administration for the drug Vancomycin HCL? a. IV, IM b. INH c. SC, IM d. IV - correct answer a. IV, IM An ESRD patient is being treated for anemia and their HCT rea...

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3 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 6 Quiz Correctly Solved 2024. A female patient is getting a right and left breast mastectomy bra with integrated form breast prosthesis. What HCPCS Level II code is reported? a. L8002 b. L8002-50 c. L8001-50 d. L8000 - correct answer a. L8002 Patient is given 15 mg of methotrexate sodium IM for rheumatoid arthritis given from 5 mg vials. What HCPCS Level II code and unit(s) is reported? a. J8610 x 6 b. J9260 c. J9250 x 5 d. J9250 x 3 - correct answer d. J9250...

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3 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 6 Review Practice Test 2024.A 65 year-old patient is seen in her physician's office with a laceration on her forehead. The cut is not deep for a suture repair. The physician decides to repair the wound with tissue adhesive. How would this be billed? a. A4364 b. A4452 c. G0168 d. C1765 - correct answer c. G0168 What is the HCPCS Level II code for the replacement of a cochlear implant transmitting coil? a. L8614 b. L8615 c. L8617 d. L8618 - correct answer c. L8...

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7 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 6 Terminology Practice Test 2024.g - correct answer Grams IM - correct answer Intramuscular IV - correct answer Intravenous mcg - correct answer micrograms mg - correct answer milligrams ml - correct answer milliliters SQ - correct answer subcutaneous Advanced Beneficiary Notice (ABN) - correct answer A standardized form that explains to the patient why Medicare may deny the particular service or procedure. An ABN protects the provider's financial inter...

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2 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 7 Practical Application Questions 2024. Use CPB Chapter 7_Case to answer questions 1 & 2. A 40-year-old patient is trying Botox® for her chronic migraines. According to the policy, what are the symptom parameters that must be documented? a. The patient has chronic migraines more than 15 days per month, with headaches lasting 4 hours a day or longer. b. There are not specific documentation requirements for the use of Botox® for chronic migraines. c. The patient has ...

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6 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 7 Quiz Correctly Answered Test 2024, A patient has a breast biopsy with placement of localization device (19083) with subsequent mastectomy (19301) at the same session after the biopsy is proven to be malignant. What modifier would be used for this scenario? a. 59 b. 58 c. 25 d. 78 - correct answer b. 58 Medicare will consider Magnetic Resonance Imaging of the Brain medically reasonable and necessary when used to aid in the diagnosis of lesions of the brain and to as...

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3 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 7 Review Test Questions 2024. MUE is the acronym for: a. Medicare Unlikely Edits b. Medically Unnecessary Edits c. Medicare Unnecessary Edits d. Medically Unlikely Edits - correct answer d. Medically Unlikely Edits Based on NCCI edits, when a procedure is bundled and has a CCM indicator of 0 - which of the following Modifiers is allowed? a. 51 b. 59 c. 25 d. Modifiers are not allowed - correct answer d. Modifiers are not allowed Which of the following is con...

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6 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 8 Practical Application Correctly Answered 2024. 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 Pr...

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6 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 8 Quiz With Answers 2024.Prior authorization is reported in Item 23. What other information can be reported in this area of the CMS-1500 claim form? a. Unlisted CPT® code(s) b. mammography pre-certification number c. patient identification number d. patient account number - correct answer b. mammography pre-certification number What is the type of bill code that is reported for a free standing clinic? a. 073X b. 074X c. 085X d. 075X - correct answer a. 073X ...

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3 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 8 Review Practice Questions 2024.Which statement is TRUE regarding condition codes for the UB-04 claim form? Selected Answer: d. a. A condition code identified the department for the revenue of the procedure. b. Condition codes are listed in the order of occurrence instead of numerical order. c. Condition codes are reported only on the CMS-1500 claim form. d. A condition code is used to indicate an inpatient service is reported on an outpatient claim. - correct answer ...

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15 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 9 Quiz With Complete Answers 2024.When a claim has been paid, an EOB is sent to: a. the clearinghouse. b. the patient. c. the provider. d. the insurance company. - correct answer b. the patient. Cost based fee schedules are developed using which of the following: a. RBRVS methodology b. total costs of every procedure or service listed in the CPT® c. total cost of all of the procedures the physician will perform d. malpractice insurance and office operating cos...

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6 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 9 Review Test 2024.A ______ indicates the location or type of service provided for an inpatient and is reported with _______. a. Revenue code; four-digit code b. Revenue code; three-digit code c. CPT code; five-digit code d. MSDRG code; three-digit code - correct answer a. Revenue code; four-digit code Which of the following documentation is NOT needed for an audit? a. Encounter form b. Medical record c. Explanation of Benefits d. CMS-1500 claim form - correct a...

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8 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 10 Quiz Clearly Answered 2024. What is the first step in working a denied claim? a. Resubmit the claim b. Contact the carrier c. Appeal the claim d. Determine and understand why the claim was denied - correct answer d. Determine and understand why the claim was denied Which of the following is the highest level of the appeals process of Medicare? a. Reconsideration b. Judicial Review c. Appeals Council d. Administrative Law Judge - correct answer b. Judicial Re...

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3 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 10 Review Study Questions 2024.Which statement is TRUE regarding the Prompt Payment Act? a. Patients are required to pay patient balances within 30 days. b. Patient balances are dismissed if a statement is not sent to the patient within 30 days. c. Federal agencies are not required to respond to all clean claims within 30 days of receipt. d. Federal agencies are required to pay clean claims within 30 days of receipt. - correct answer d. Federal agencies are required to p...

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8 pages

Written in 2023/2024

Grade A+

ROSEGRADES

AAPC CPB - Chapter 11 Quiz Correctly Answered 2024.Which coverage under TRICARE is a Medicare wrap around plan? a. TRICARE for Life b. TRICARE Reserve Select c. TRICARE Prime d. CHAMPVA - correct answer a. TRICARE for Life A patient has Medicare and a Medigap policy. Box 13, signature on file, is checked off on the electronic claim submission. An EOMB is received with remittance notice MA19. What does the office need to do? a. Nothing. This means the claim has been crossed over to t...

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3 pages

Written in 2023/2024

Grade A+

ROSEGRADES