AAPC CPB Chapter 11 Practical 2023

AAPC CPB Chapter 11 Practical 2023Use CPB Chapter 11_Case to answer questions 1 & 2. After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect? I. The provider must accept assignment II. Provider name conflict III. Medicare ID number is missing information IV. Medicaid ID number is missing information V. Medicare ID number in the wrong field VI. Medicaid ID number in the wrong field VII. Ordering provider name and NPI VIII. Place of service code IX. Diagnosis code(s) X. Diagnosis pointer(s) A. I, V, VI, and X B. I, VI, IX, and X C. III, IV, VIII, and IX D. There are no errors on this claim. B. I, VI, IX, and X Response Feedback: When providers provide physician services to individuals dully entitled to Medicare and Medicaid, they are required to accept assignment. The patient's Medicaid number should be listed in item 10d. For Medicare, only one diagnosis pointer is entered per line item. Apnea NOS is not mentioned in the medical record. Use CPB Chapter 11_Case to answer the following question. What should be done to correct this claim? I. Correct assignment on the claim. II. Correct primary insurance information on the claim. III. Correct secondary insurance information on the claim. IV. Correct the provider information on the claim. V. Correct the diagnosis on the claim. VI. Correct the diagnosis pointer(s) on the claim. A. III and IV B. I, III, V, and VI C. I - VI D. None of the above. B. I, III, V, and VI Response Feedback: When providers provide physician services to individuals dully entitled to Medicare and Medicaid, they are required to accept assignment. The patient's Medicaid number should be listed in item 10d. For Medicare, only one diagnosis pointer is entered per line item. Apnea NOS is not mentioned in the medical record. 00:08 01:15 Use CPB Chapter 11 Case to answer questions 3 and 4. After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect? I. Patient name II. Primary insurance ID number III. Authorization number IV. Place of service V. Site of service VI. Provider NPI number VII. CPT® code VIII. Modifier IX. Diagnosis conflict X. Units of service A. I, III, V, VII, and IX B. I and VII C. I, II, and VII D. None of the above. B. I and VII Response Feedback: The patient's name on the claim form must be identical to the name on the patient's Medicare card. The patient is an established patient and a new patient visit is reported. Use CPB Chapter 11_Case to answer the following question. What should be done to correct this claim? I. Correct the patient's name on the claim. II. Review the medical record to verify the diagnosis code. III. Add the correct modifier. IV. Add the authorization number. V. Correct the CPT® code. A. III and IV B. I and V C. I and II D. None of the above. B. I and V Response Feedback: The name on the claim form should be changed to BROWN DONNY JOE. The CPT code for a level IV established patient office visit is 99214. Use CPB Chapter 11_Case to answer questions 5 & 6. After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect? I. The provider must accept assignment II. Provider name conflict III. Medicare ID number is missing information IV. Medicaid ID number is missing information V. Medicare ID number in the wrong field VI. Medicaid ID number in the wrong field VII. Units are missing VIII. CPT® codes are incorrect IX. Modifier use X. Diagnosis pointer A. IV only B. I, IV, VI, VII, and IX C. II, III, V, VIII, and X D. None of the above. D. None of the above. Response Feedback: The Medicaid number is missing in Item 10d. Use CPB Chapter 11_Case to answer questions 5 & 6. Which of the following statements is true regarding this case? A. The Medicaid ID number is not listed in the correct Item on the claim. B. The CPT® code is not listed in the correct Item on the claim. C. Multiple units should be reported with code 99214. D. None of the above. A. The Medicaid ID number is not listed in the correct Item on the claim. Response Feedback: The Medicaid number is missing in Item 10d. Use CPB Chapter 11_Case to answer this question. According to the LCD, what diagnosis pointer should be listed in Item E of the CMS-1500 claim form corresponding to CPT® code 93010? A. B B. A C. A or B D. None of the given diagnoses are covered according to this LCD. B. A Response Feedback: According to the LCD, myocardial infarction (I21.3) is covered diagnoses for 93010. Use CPB Chapter 11_Case to answer the following question: After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect? I. The provider must accept assignment II. Provider name conflict III. Medicare ID number is missing information IV. Medicaid ID number is missing information V. Medicare ID number in the wrong field VI. Medicaid ID number in the wrong field VII. Ordering provider name and NPI VIII. Place of service code IX. Diagnosis code(s) X. Diagnosis pointer(s) A. VIII and IX B. I, VI, VIII, IX, and X C. III, IV, and IX D. There are no errors on this claim. A. VIII and IX Response Feedback: Place of service 11 is for an office visit. This visit was to the emergency department which is reported with place of service 23. Acute Myocardial Infarction is reported with ICD-10-CM code I21.9.