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Mock CPB Exam Questions and Answers 100% Accurate Solutions
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Mock CPB Exam Questions andAnswers 100% Accurate Solutions
Court decisions that establish a standard use legal decisions to serve as
authoritative rules or patterns in future similar cases. The legal term for
standard is ______.
a. decision
b. example
c. precedent
d. statute - -precedent
-Which is established in advance and based on reported health care charges
from which a predetermined per diem rate is determined?
a. prospective cost-based rate
b. retrospective reasonable cost system
c. prospective price-based rate
d. site-of-service differential - -prospective cost-based rate
-Which is a legal action that can be used to recover a debt and is usually a
last resort for a medical practice?
a. litigation
b. mediation
c. adjudication
d. subrogation - -litigation
-When a child lives with both parents, and each parent subscribes to a
different health insurance plan, the primary and secondary policies are
determined by applying the birthday rule. The individual who holds the
primary policy for dependent children is the spouse whose birth ______.
a. month and day occur earlier in the calendar year
b. year occurs earlier
c. day occurs earlier in the month
d. month, day, and year occur earlier - -month and day occur earlier in the
calendar year
-TRICARE deductibles are applied to the government's ______ year, which
runs from October 1 of one year to September 30 of the next.
a. fiscal
b. calendar
c. consecutive
d. sequential - -fiscal
-The Resource Based Relative Value Scale (RBRVS) system reimburses
physicians' practice expenses using a ______.
,a. usual and reasonable payment basis
b. prospective payment system
c. guaranteed issue method
d. fee schedule - -fee schedule
-OSHA has special significance for those employed in health care because
employers are required to obtain and retain manufacturers' Material Safety
Data Sheets (MSDS), which contain information about ______ used on site.
Training employees in the safe handling of these substances is also required.
a. vaccinations and drugs
b. possibly harmful agents only
c. oral, IM, and IV medications
d. chemical and hazardous substances - -chemical and hazardous
substances
-The BCBS PPO plan is sometimes described as a subscriber-driven program,
and BCBS substitutes the term subscriber or ______ for policyholder.
a. payer
b. provider
c. patient
d. member - -member
-Which type of automobile insurance pays for damage to a covered vehicle
caused by hitting an object or being hit during an automobile accident?
a. liability
b. collision
c. personal injury protection
d. comprehensive - -collision
-BlueShield plans were created as the result of a resolution passed by the
House of Delegates at an American Medical Association meeting in 1938.
This resolution supported the concept of ______ health insurance that would
encourage physicians to cooperate with prepaid health care plans.
a. voluntary
b. mandatory
c. commercial
d. profit - -voluntary
-Which of the following is an example of abuse?
a. submitting claims for services and procedures knowingly not provided
b. misrepresenting ICD-10-CM and CPT/HCPCS codes to justify payment
c. billing noncovered services/procedures as covered services/procedures
d. falsifying health care certificates of medical necessity plans of treatment -
-billing noncovered services/procedures as covered services/procedures
, -Which code represents a new patient exam in which the physician
documents a detailed history, detailed examination, and medical decision
making of low complexity?
a. 99203
b. 99204
c. 99214
d. 99213 - -99203
-Which punctuation is used in the ICD-10-CM index to identify manifestation
codes and in the ICD-10-CM index and tabular list to enclose abbreviations,
synonyms, alternative wording, or explanatory phrases?
a. braces
b. parentheses
c. colons
d. slanted brackets - -slanted brackets
-Which code represents foot, abduction rotation bar, without shoes?
a. L3170
b. L3150
c. L3140
d. L3160 - -L3150
-The Medicare durable medical equipment, prosthetics/orthotics, and
supplies (DMEPOS) fee schedule reimburses DMEPOS either ______ percent of
the actual charge for the item or the fee schedule amount, whichever is
lower.
a. 80
b. 20
c. 50
d. 100 - -80
-Which claims are organized by year and are generated for providers who do
not accept assignment?
a. clean claims
b. unassigned claims
c. open claims
d. closed claims - -unassigned claims
-Which is the financial record source document used by health care
providers and other personnel in a physician's office setting to record treated
diagnoses and services rendered to the patient during the current visit?
a. superbill
b. explanation of benefits
c. CMS-1500 claim
d. remittance advice - -superbill
, -Which classification system was developed by the World Health
Organization (WHO) and used to collect data for statistical purposes?
a. National Drug Codes
b. Current Procedural Terminology
c. International Classification of Diseases
d. Healthcare Common Procedure Coding System - -International
Classification of Diseases
-Where is the first-listed diagnosis reported on the CMS-1500 claim?
a. Block 24E
b. Block 24D
c. Block 21A
d. Block 24A - -Block 21A
-What type of codes containing "emerging technology," are temporary codes
assigned for data collection, and are still used by some third-party payers?
a. Category II codes
b. Category III codes
c. Category I codes
d. Category IV codes - -Category III codes
-Which are the amounts owed to a business for services or goods provided?
a. accounts payable
b. allowed charges
c. assignment of benefits
d. accounts receivable - -accounts receivable
-Atherosclerosis of native arteries of extremities with gangrene, bilateral
legs is represented by which ICD-10-CM code?
a. I70.263
b. I70.262
c. I70.268
d. I70.261 - -I70.263
-Secondary insurance is the insurance plan that is billed after the primary
insurance plan has paid its contracted amount and the provider's office has
received a(n) ______ from the primary payer.
a. encounter form
b. remittance advice
c. CMS-1500 claim
d. explanation of benefits - -remittance advice
-The primary care provider (PCP) is responsible for ______.
a. providing nonessential health care services to all patients
b. supervising and coordinating health care services for enrollees
c. denying all referrals to specialists and inpatient hospital admissions
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