AAPC CPB Practice Actual Exam Latest

AAPC CPB Practice Actual Exam Latest Update Answers Rated A+

A female patient who was involved in an auto accident presents to the emergency department (ED) for evaluation. She does not have any complaints. The provider evaluates her and determines there are no injuries. The provider informs the patient to come back to the ED or see her primary care physician if she develops any symptoms. How is the claim processed for this encounter?

• The medical insurance is billed primary and the auto insurance is

billed secondary.

• The auto insurance is billed primary and the medical insurance is

billed secondary.

• Bill the medical insurance first to receive a denial and then submit

with the remittance advice to the auto insurance.

• Bill only the medical insurance because the auto insurance only

covers damage to the vehicle, not medical expenses. -ANSWER-B.The auto insurance is billed primary and the medical insurance is billed secondary.

What forms need to be submitted when billing for a work-related injury?

• Progress reports, and WC-1500 claim form

B. UB-04

• First Report of Injury form and an itemized statement

• First Report of Injury form, progress reports, and CMS-1500 claim

form -ANSWER-D. First Report of Injury form, progress reports, and CMS-1500 claim form

A document provided to Medicare patients explaining their financial

responsibility if Medicare denies a service is a(n):

• Notice of Financial Liability
• Advance Beneficiary Notice
• Insurance waiver
• Explanation of Benefits -ANSWER-B. Advance Beneficiary Notice

What is an Accountable Care Organization (ACO)?

• Groups of doctors, hospitals, and other health care providers who

coordinate high quality care to Medicare patients.

• An insurance carrier that provides a set fee based on the diagnosis

of the patient.

• A group of providers who contract with a third party administrator to

pay fee for service for services.

• Hospitals who see a subset of patients for cost efficiency. -

ANSWER-A. Groups of doctors, hospitals, and other health care providers who coordinate high quality care to Medicare patients.

A new patient presents for her annual exam and has no complaints.She is scheduled to see the physician assistant (PA). How should services be billed ?

• Bill under the PA.
• A new patient can be billed incident to the physician.
• The PA cannot see new patients.

• Reschedule the patient with the physician -ANSWER-A. Bill under

the PA.

CPT® codes 12032 and 12001 were reported together for a 2.6 cm intermediate repair of a laceration to the right arm and a 2.5 cm simple repair of a laceration to the left arm. 12001 was denied as a bundled service. What action should be taken by the biller (following the CPT® guidelines)?

• Write-off the charge for 12001 as it is a bundled procedure.
• Resubmit a corrected claim as 12032, 12001-59.
• Transfer the charge to patient responsibility.
• Resubmit a corrected claim as 12032, 12001-51. -ANSWER-B.

Resubmit a corrected claim as 12032, 12001-59.

According to CMS, which of the following services are included in the global package for surgical procedures?

• Surgical procedure performed

II. E/M visits unrelated to the diagnosis for which the surgical procedure is performed III. Local infiltration, digital block, or topical anesthesia IV. Treatment for postoperative complication which requires a return trip to the operating room (OR)V. Writing Orders VI. Postoperative infection treated in the office

A. I, III, V, VI

B. I, IV, V

C. I, II, III, V

D. I-VI -ANSWER-A. I, III, V, VI

Which CPT® code below can be reported with modifier 51?

A. 17004

B. 17312

C. 19101

D. 19126 -ANSWER-C. 19101

A HCPCS/CPT® code is assigned "1" in the MUE file. What does this indicate?

• Code pairs cannot be reported together.
• Codes can be reported together if documented. Append modifier

59.

• The code can only be reported for one unit of service on a single

date of service.

• Medically unlikely the code pair is performed together. -ANSWER-
• The code can only be reported for one unit of service on a single

date of service.

Electronic Healthcare Transactions and code sets are required to be used by health plans, healthcare clearinghouses and healthcare providers that participate in electronic data interchanges. Which of the following are requirements for the code sets?

• Dental services are reported with CDT codes

II. Inpatient procedures are reported with HCPCS Level II codes III. Diagnosis codes are reported with ICD-10-CM and ICD-10-PCS codes IV. Outpatient services are reported with CPT® and HCPCS Level II codes

• Physician services are reported with ICD-10-PCS codes

• I and IV