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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 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 assist in therapeutic decision mak...

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 - 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 considered to be an anat...

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. 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 d. A condition code is used ...

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 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 Provider signature X Work re...

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. 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 When reporting proc...

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. 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 d. A condition code is use...

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 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 costs - correct answer c. total ...

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; 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 answer c. Ex...

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 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 pay clean claims within...

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 - correct answer Used to ensure that insurance claims are not being paid multiple times Coverage Terminated - correct answer This denial occurs when the patient does not have coverage with the insurance c...