AAPC CPB EXAM / AAPC CPB ACTUAL EXAM
TEST BANK ALL 200 REAL EXAM QUESTIONS
WITH WELL ELABORATED ANSWERS
The office policy for claims follow-up is to prioritize the insurance balance accounts past 90
days by highest outstanding balance. Based on the A/R report provided, which payer type and
aging category would be one of the top priorities on which to focus collection efforts? -
CORRECT ANSWER>>workers' compensation, 121+ days
Using the fee schedule and the payment policy provided, what is the expected reimbursement
(including patient responsibility) when a provider performs a nasal endoscopy and dilation of
the left maxillary sinus (31295) and a diagnostic nasal endoscopy of the right maxillary sinus
(31233)? - CORRECT ANSWER>>$2475
Policy applies to all professional services performed in an office place of service: When a
significant, separately identifiable E/M service (appended with modifier 25) and any service
that has a global period indicator—as designated by CMS of 0, 10, 90 or YYY—is performed on
the same day, the E/M service will be reimbursed at 50% of the contracted allowable. When
performed in a facility, both services are paid at 100%.
When the E/M value is greater than the procedure, the reduction will be applied to the global
procedure code.
Based on the remittance advice and the payment policy provided, what action is required for
this claim? - CORRECT ANSWER>>D. The claim did not pay correctly. Both services should be
paid at 100%. Contact the payer to reprocess the claim for full payment.
Balloon Sinusplasty Medical Coverage Policy
According to the LCD, how is an extracapsular cataract surgery with insertion of an intraocular
lens for a drug induced cataract in the left eye reported? - CORRECT ANSWER>>66984, H26.32,
T38.0X5A
, I. Primary insurance
II. Primary insurance ID number
III. Relationship to the insured
IV. Place of service
V. Provider NPI
VI. CPT® code(s)
VII. Modifier
VIII. Diagnosis code correlation
IX. Units of service
X. Service Facility Location Information
(Robert Roberts) - CORRECT ANSWER>>VI , VIII and X
The provider performs an office visit with an expanded problem focused history, expanded
problem focused exam and low MDM to manage the patient's hypertension. The provider also
destroys two plantar warts. How is this reported? - CORRECT ANSWER>>99213-25, 17110
What is the correct HCPCS Level II code for Depo-Provera (medroxyprogesterone acetate)
injection of 100 mg? - CORRECT ANSWER>>J1050 x 100
55-year-old female presents to the office with ongoing history of type I diabetes which has
been controlled with insulin. During the exam the physician notes that gangrene has set in due
to the diabetic peripheral angiopathy on her left great toe. Patient is recommended to see a
general surgeon for treatment of the gangrene on her left great toe. - CORRECT
ANSWER>>E10.52
A dermatologist performed an excision of a squamous cell carcinoma from the patients
forehead with a 1.2 cm excised diameter. The excision site required an intermediate wound
TEST BANK ALL 200 REAL EXAM QUESTIONS
WITH WELL ELABORATED ANSWERS
The office policy for claims follow-up is to prioritize the insurance balance accounts past 90
days by highest outstanding balance. Based on the A/R report provided, which payer type and
aging category would be one of the top priorities on which to focus collection efforts? -
CORRECT ANSWER>>workers' compensation, 121+ days
Using the fee schedule and the payment policy provided, what is the expected reimbursement
(including patient responsibility) when a provider performs a nasal endoscopy and dilation of
the left maxillary sinus (31295) and a diagnostic nasal endoscopy of the right maxillary sinus
(31233)? - CORRECT ANSWER>>$2475
Policy applies to all professional services performed in an office place of service: When a
significant, separately identifiable E/M service (appended with modifier 25) and any service
that has a global period indicator—as designated by CMS of 0, 10, 90 or YYY—is performed on
the same day, the E/M service will be reimbursed at 50% of the contracted allowable. When
performed in a facility, both services are paid at 100%.
When the E/M value is greater than the procedure, the reduction will be applied to the global
procedure code.
Based on the remittance advice and the payment policy provided, what action is required for
this claim? - CORRECT ANSWER>>D. The claim did not pay correctly. Both services should be
paid at 100%. Contact the payer to reprocess the claim for full payment.
Balloon Sinusplasty Medical Coverage Policy
According to the LCD, how is an extracapsular cataract surgery with insertion of an intraocular
lens for a drug induced cataract in the left eye reported? - CORRECT ANSWER>>66984, H26.32,
T38.0X5A
, I. Primary insurance
II. Primary insurance ID number
III. Relationship to the insured
IV. Place of service
V. Provider NPI
VI. CPT® code(s)
VII. Modifier
VIII. Diagnosis code correlation
IX. Units of service
X. Service Facility Location Information
(Robert Roberts) - CORRECT ANSWER>>VI , VIII and X
The provider performs an office visit with an expanded problem focused history, expanded
problem focused exam and low MDM to manage the patient's hypertension. The provider also
destroys two plantar warts. How is this reported? - CORRECT ANSWER>>99213-25, 17110
What is the correct HCPCS Level II code for Depo-Provera (medroxyprogesterone acetate)
injection of 100 mg? - CORRECT ANSWER>>J1050 x 100
55-year-old female presents to the office with ongoing history of type I diabetes which has
been controlled with insulin. During the exam the physician notes that gangrene has set in due
to the diabetic peripheral angiopathy on her left great toe. Patient is recommended to see a
general surgeon for treatment of the gangrene on her left great toe. - CORRECT
ANSWER>>E10.52
A dermatologist performed an excision of a squamous cell carcinoma from the patients
forehead with a 1.2 cm excised diameter. The excision site required an intermediate wound
