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AAPC CPB Bundled Exams 2024/2025 with complete solution
AAPC CPB Bundled Exams 2024/2025 with complete solution
[Show more]AAPC CPB Bundled Exams 2024/2025 with complete solution
[Show more]Case 7 - Clearinghouse Rejection Report 
Status: 7/6/20XX Contents: REJ - untimely filing; UTF 
Patient Name: Smith, Hattie 
Patient Number: MRN7862 
Payer: AAPC Health Plan 
Submission Date: 7/5/X2 
Date of Service: 12/23/X1 
Charge: $1200.00 
Provider: Dailey, David 
According to this clearinghous...
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Add to cartCase 7 - Clearinghouse Rejection Report 
Status: 7/6/20XX Contents: REJ - untimely filing; UTF 
Patient Name: Smith, Hattie 
Patient Number: MRN7862 
Payer: AAPC Health Plan 
Submission Date: 7/5/X2 
Date of Service: 12/23/X1 
Charge: $1200.00 
Provider: Dailey, David 
According to this clearinghous...
A 40-year-old patient has severe pain in his lower back. After multiple surgeries, physical therapy, and 
various medications without relief, the provider performed percutaneous epidural lysis of adhesions. An 
epidural catheter is placed and an epidurography is performed. A series of injections are...
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Add to cartA 40-year-old patient has severe pain in his lower back. After multiple surgeries, physical therapy, and 
various medications without relief, the provider performed percutaneous epidural lysis of adhesions. An 
epidural catheter is placed and an epidurography is performed. A series of injections are...
A 3 year-old is seen for ear infections in both of his ears. The provider's assessment indicates that the 
infection is worse in the child's right ear. What ICD-10-CM code(s) should be assigned? 
a. H66.92, H66.91 
b. H66.90 
c. H66.91, H66.92 
d. H66.93 - Answer-d. H66.93 
A patient complains of ...
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Add to cartA 3 year-old is seen for ear infections in both of his ears. The provider's assessment indicates that the 
infection is worse in the child's right ear. What ICD-10-CM code(s) should be assigned? 
a. H66.92, H66.91 
b. H66.90 
c. H66.91, H66.92 
d. H66.93 - Answer-d. H66.93 
A patient complains of ...
Patient presents with difficulty speaking, facial droop, and she is unable to close her left eye. She has no 
other complaints. She is diagnosed with Bell's palsy. She is prescribed Corticosteroids. She will return in 3 
days for follow-up. What ICD-10-CM code(s) is/are reported? 
a. G51.0, R29.810...
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Add to cartPatient presents with difficulty speaking, facial droop, and she is unable to close her left eye. She has no 
other complaints. She is diagnosed with Bell's palsy. She is prescribed Corticosteroids. She will return in 3 
days for follow-up. What ICD-10-CM code(s) is/are reported? 
a. G51.0, R29.810...
What does no-fault insurance mean? 
a. The insurance will pay only if no one was found to be at fault. 
b. The insurance will pay regardless of who was at fault. 
c. Both insurances pay evenly when no one is found to be at fault. 
d. No payments or benefits are paid. - Answer-b. The insurance will p...
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Add to cartWhat does no-fault insurance mean? 
a. The insurance will pay only if no one was found to be at fault. 
b. The insurance will pay regardless of who was at fault. 
c. Both insurances pay evenly when no one is found to be at fault. 
d. No payments or benefits are paid. - Answer-b. The insurance will p...
Medicare Supplement Insurance policies or Medigap is sold by: 
a. Medicare 
b. Medicaid 
c. Private insurance companies 
d. Healthcare providers - Answer-c. Private insurance companies 
Albert has purchased a Medigap policy to supplement his Medicare benefits. To which entity will Albert 
pay his mo...
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Add to cartMedicare Supplement Insurance policies or Medigap is sold by: 
a. Medicare 
b. Medicaid 
c. Private insurance companies 
d. Healthcare providers - Answer-c. Private insurance companies 
Albert has purchased a Medigap policy to supplement his Medicare benefits. To which entity will Albert 
pay his mo...
A family has health insurance coverage from both the father and mother. The father's birthday is May 29, 
1989 and the mother's birthday is May 26, 1990. Which insurance would be primary for their three 
children? 
A. The father's insurance would be primary because he was born before the mother. ...
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Add to cartA family has health insurance coverage from both the father and mother. The father's birthday is May 29, 
1989 and the mother's birthday is May 26, 1990. Which insurance would be primary for their three 
children? 
A. The father's insurance would be primary because he was born before the mother. ...
An internist sees a 20-year-old patient for an office visit. The patient needs to see an endocrinologist for 
a consultation regarding her diabetes. The internist is a participating provider in her plan. She can choose 
any provider she wishes for her consultations, but she will save money if she se...
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Add to cartAn internist sees a 20-year-old patient for an office visit. The patient needs to see an endocrinologist for 
a consultation regarding her diabetes. The internist is a participating provider in her plan. She can choose 
any provider she wishes for her consultations, but she will save money if she se...
A provider removes a skin lesion in an ASC and receives a denial from the insurance carrier that states 
"Lower level of care could have been provided." What steps should the biller take? 
a. Write-off the charge. 
b. Check with the provider and write an appeal to the insurance carrier explaining ...
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Add to cartA provider removes a skin lesion in an ASC and receives a denial from the insurance carrier that states 
"Lower level of care could have been provided." What steps should the biller take? 
a. Write-off the charge. 
b. Check with the provider and write an appeal to the insurance carrier explaining ...
Blue Cross/Blue Shield offers which type of Medicare plan? 
a. Medicare Plus 
b. Medicare Advantage 
c. Medicare Part G 
d. Medicare Add-on - Answer-b. Medicare Advantage 
A claim is submitted for a patient who suffered a fractured femur. The diagnosis code that was submitted 
is S82.401A, with the ...
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Add to cartBlue Cross/Blue Shield offers which type of Medicare plan? 
a. Medicare Plus 
b. Medicare Advantage 
c. Medicare Part G 
d. Medicare Add-on - Answer-b. Medicare Advantage 
A claim is submitted for a patient who suffered a fractured femur. The diagnosis code that was submitted 
is S82.401A, with the ...
60-year-old woman is seeking help to quit smoking. She makes an appointment to see Dr. Lung for an 
initial visit. The patient has a constant cough due to smoking and some shortness of breath. No night 
sweats, weight loss, night fever, CP, headache, or dizziness. She has tried patches and nicotine ...
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Add to cart60-year-old woman is seeking help to quit smoking. She makes an appointment to see Dr. Lung for an 
initial visit. The patient has a constant cough due to smoking and some shortness of breath. No night 
sweats, weight loss, night fever, CP, headache, or dizziness. She has tried patches and nicotine ...
CMS defines ___________ as billing for a lower level of care than is supported in documentation, making 
false statements to obtain undeserved benefits or payment from a federal healthcare program, or billing 
for services that were not performed. 
a. Fraud 
b. Abuse 
c. a Stark violation 
d. an Ant...
Preview 2 out of 8 pages
Add to cartCMS defines ___________ as billing for a lower level of care than is supported in documentation, making 
false statements to obtain undeserved benefits or payment from a federal healthcare program, or billing 
for services that were not performed. 
a. Fraud 
b. Abuse 
c. a Stark violation 
d. an Ant...
NCDs are released by which of the following entities: - CMS 
A health plan sends a request for medical records in order to adjudicate a claim. Does the office have to 
notify the patient or have them sign a release to send the information? - no 
____ sets standards and directives to protect workers ...
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Add to cartNCDs are released by which of the following entities: - CMS 
A health plan sends a request for medical records in order to adjudicate a claim. Does the office have to 
notify the patient or have them sign a release to send the information? - no 
____ sets standards and directives to protect workers ...
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