AAPC CPB (package deal ) 2024/2025 already passed

AAPC CPB - Chapter 14 QuizWhat type of state worker's compensation coverage allows an employer to set aside money to cover medical expenses and other related benefits for its employees? a. State insurance fund b. Self-insurance plans c. Commercial workers' compensation insurance d. Combinati...

AAPC CPB - Chapter 13 Review On 05/02/19, a claim for a fine needle aspiration biopsy with ultrasound guidance was reported with CPT code 10022, ICD-10-CM code D49.2 for DOS 05/01/2019. Why would the claim be denied? a. Not medically necessary b. Invalid CPT code for DOS c. Invalid ICD-10-CM c...

AAPC CPB - Chapter 13 QuizWhich of the following denials is one of the leading reasons a claim is denied and can be prevented by accurate intake information being collected every time? a. Medical necessity b. Coordination of Benefits c. Request for medical records not received d. Incorrect pat...

AAPC CPB - Chapter 12 ReviewThe term for the set payment that the member pays to the healthcare provider on the day of service is the: a. office visit fee. b. co-insurance. c. copay. d. co-signer. - correct answer c. copay. Response Feedback: A copayment or copay is the set amount the in...

AAPC CPB - Chapter 12 QuizWhich type of insurance plan is a federal and state program that provides coverage to the low-income population? a. Medicare b. HMO c. Medicaid d. PPO - correct answer c. Medicaid Response Feedback: Medicaid is a joint federal and state program that provides hos...

AAPC CPB - Chapter 11 ReviewMedicare's payment amount for services are determined by which of the following formulas? a. Sustainable growth rate (SGR) X Geographic Practice Cost Index (GPCI) = Medicare payment b. Total RVU X Conversion factor = Medicare payment c. Total Practice Expense (PE) X...

AAPC CPB - Chapter 11 QuizWhich 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...

AAPC CPB - Chapter 10 Terminology Bad Debt - correct answer Accounts receivable or money owed that will likely remain uncollectable and will be written off Bankruptcy - correct answer Legal proceeding involving a person who is unable to repay outstanding debts Coordination of Benefits - corre...

AAPC CPB - Chapter 10 ReviewWhich 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 a...

AAPC CPB - Chapter 9 ReviewA ______ 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...

AAPC CPB - Chapter 9 QuizWhen 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 co...

AAPC CPB - Chapter 8 ReviewWhich 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. Con...

AAPC CPB - Chapter 8 QuizPrior 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. ...

AAPC CPB - Chapter 8 Practical ApplicationUsing 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 p...

AAPC CPB - Chapter 8 ExamWhich 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. Condi...

AAPC CPB - Chapter 7 Review 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...

AAPC CPB - Chapter 7 QuizA 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 ...

AAPC CPB - Chapter 6 ReviewA 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 - correc...

AAPC CPB - Chapter 6 QuizA 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 ...

AAPC CPB - Chapter 6 Practical Application 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 rou...

AAPC CPB - Chapter 5 ReviewPatient 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...

AAPC CPB - Chapter 4 QuizWhat 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. IC...

AAPC CPB - Chapter 3 ReviewWhat information can be released based on this Disclosure form? AAPC Physician Practice are authorized to make the disclosure. The type of information to be used or disclosed is as follows: ____ Problem list ____ Medication list ____ List of allergies ____ Immun...

AAPC CPB - Chapter 3 ReviewWhat information can be released based on this Disclosure form? AAPC Physician Practice are authorized to make the disclosure. The type of information to be used or disclosed is as follows: ____ Problem list ____ Medication list ____ List of allergies ____ Immun...

AAPC CPB - Chapter 3 Review What information can be released based on this Disclosure form? AAPC Physician Practice are authorized to make the disclosure. The type of information to be used or disclosed is as follows: ____ Problem list ____ Medication list ____ List of allergies ____ Imm...

AAPC CPB - Chapter 3 Quiz Listed below are examples of patient reminders for appointments. Which one is HIPAA compliant? a. "This is the obstetrical office calling to remind you of your appointment Tuesday, April 12 at 9 am for your annual exam." b. "This is Dr. Smith's office calling to re...

AAPC CPB - CHAPTER 3: QUESTIONS Which of the following does NOT qualify a patient for coverage under Medicare? a. End Stage Renal Disease (ESRD) b. Age 65 or older c. Under age 65 with disabilities d. Low income individual - correct answer d. Low income individual The insurance claim proce...

AAPC CPB - Chapter 2 ReviewWhat is the largest health program in the United States? a. Blue Cross Blue Shield b. Medicare c. Medicaid d. TRICARE - correct answer b. Medicare Which of the following services is NOT covered under Medicare Part B? a. Cardiovascular disease screening b. Diab...

AAPC CPB - CHAPTER 2: QUESTIONSWhy must a provider obtain an NPI number? I. To submit claims II. To prove that he is licensed III. To be HIPAA compliant IV. To guarantee payment by a health plan a. I, II, III b. II, III, IV c. I, II, III, IV d. I, III - correct answer d. I, III A patien...

AAPC CPB - Chapter 1 ReviewWhat does the acronym PHI stand for? a. Patient Healthcare Information b. Patient History of Illness c. Protected Health Information d. Protected Healthcare Index - correct answer c. Protected Health Information A new radiology company opens in town. The manager c...

AAPC CPB - Chapter 1 QuizEight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? a. Payment and remittance advice b. Eligibility in a health plan c. Coordination of benefits d. Physician uniqu...

AAPC CPB - CHAPTER 1: QUESTIONS Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? a. Payment and remittance advice b. Eligibility in a health plan c. Coordination of benefits d. Physici...

AAPC Chapter 1 CPBA physician received office space at a reduced rate for referring patients to the hospital's outpatient physical therapy center. What Law does this violate? 1. Anti-kickback Statute 2. Stark Law 3. False Claims Act 4. Truth in Lending Act - correct answer Anti-Kickback Statu...