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AAPC CPB - Chapter 14 Review__________ sets standards and directives to protect workers against transmission of infectious agents. a. HIPAA b. JCAHO c. NCHS d. OSHA - correct answer d. OSHA For OSHA, which employees are included as healthcare workers? I. medical staff II. maintenance staff III . housekeeping IV. food service staff V. administrative staff a. I only b. I and V c. I, III, and V d. I-V - correct answer d. I-V Which entity governs workers' compensation law? ...

AAPC CPB Ch 2 exam reviewWhat components make up the Medicare Physician Fee Schedule? Relative value units for physician work, practice expense, and professional liability insurance; the Geographical Practice Cost Index; and the conversion factor. Medicare uses the Medicare Physician Fee Schedule (MPFS) for reimbursement for physician services and other types of services. This replaced the old "customary, prevailing, and reasonable" (CPR) payment system. The MPFS is funded by Part B and is...

AAPC CPB CH 5 ReviewWhat CPT® code is reported for an MRI of the brain without contrast? 70551 Look in the CPT® Index for Magnetic Resonance Imaging (MRI)/Diagnostic/Brain which directs you to . In the numeric section of CPT®, 70551 indicates without contrast. Which reporting option below is correct use of the modifier 50? 19318-50 There is guidance under the Integumentary System/Breast/Repair and/or Reconstruction heading that states to append modifier 50 when the procedures are per...

AAPC CPB Chapter 1 ReviewFCA - correct answer False Claims Act (FCA): {"knowing" and "knowingly"}-Federal statue setting civil and criminal penalties to protect the government from being overcharged or sold substandard goods or services: -falsely billing the government -over-representing the amount of a delivered product ....or.... -under-stating an obligation to the government Minimum Necessary Standard. What should be sent if records are being requested?? - correct answer The ? req...

AAPC CPB Chapter 1Eight 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 unique identifier number d. Physician unique identifier number We have an expert-written solution to this problem! HIPAA of 1996 includes a Security Rule that is established to provide what national standa...

AAPC CPB Chapter 3 ReviewWhat is a claim that is sent for reimbursement that contains all the required data elements to process the claim referred to as? a. Submitted b. Adjudicated c. Clean Claim d. Medically necessary c. Clean Claim HIPAA Section 164.508 states that covered entities may not use or disclose protected information without a valid authorization. In what circumstances can a practice NOT release protected information with a signed authorization? a. Records sent to a p...

AAPC CPB Chapter 4 ReviewHow many chapters does ICD-10-CM contain? a. 17 b. 19 c. 22 d. 20 c. 22 What is/are the correct code(s) for a patient with type 1 diabetic neuropathy? a. E11.40 b. E90.40 c. E10.9, G62.9 d. E10.40 d. E10.40 What are the correct codes for benign hypertensive heart disease and stage 3a chronic kidney disease? a. I10, I11.9, I12.9, N18.31 b. I13.10, N18.31 c. N18.31, I13.10 d. I13.0, N18.31 b. I13.10, N18.31 Which sections of ICD-10-CM do...

AAPC CPB Chapter 6 ReviewPatient is given 15 mg of methotrexate sodium IM for rheumatoid arthritis given from 5 mg vials. What HCPCS Level II code and unit(s) is reported? a. J8610 x 6 b. J9260 c. J9250 x 5 d. J9250 x 3 d. J9250 x 3 Look in the HCPCS Level II Table of Drugs for Methotrexate Sodium, one of the routes is IM (intramuscular) directing you to code J9250. This drug is reported for 5mg. The patient received 15 mg of methotrexate. The correct way to code this injection is J925...

AAPC CPB Chapter 7 Review Who were the NCCI edits originally developed to be used by? a. Commercial Carriers b. Medicare Administrative Contractors c. Self-pay patients d. Medicare beneficiaries b. Medicare Administrative Contractors The NCCI edits have column 1 and Column 2 codes and provide an indicator to determine whether a modifier is allowed to be used. Which indicator is used to tell the biller a modifier is never allowed? a. 0 b. 1 c. 9 d. A a. 0 Which of the fol...

AAPC CPB Chapter 9 ReviewA patient with ABC insurance is seen on May 1st, and the claim is submitted on July 15 of the same year. Has the claim met the timely filing deadline? a. Yes. All payers have the same timely filing deadline of one year from date of service. b. No. All payers have a 30-day timely filing deadline. c. Maybe. ABC's timely filing policy should be reviewed to determine if the deadline was met. d. Maybe. Prepare an appeal letter just in case the claim is denied. c...