AAPC CPB - Chapter 13 Review Test Questions and Answers 2024.

AAPC CPB - Chapter 13 Review Test Questions and Answers 2024. On 05/02/19, a claim for a fine needle aspiration biopsy with ultrasound guidance was reported with CPT code 10022, ICD-10-CM code D49.2 for DOS 05/01/2019. Why would the claim be denied? a. Not medically necessary b. Invalid CPT code for DOS c. Invalid ICD-10-CM code for DOS d. Timely filing - correct answer b. Invalid CPT code for DOS Response Feedback: Rationale: CPT™ code 10022 was deleted in 2019. CPT® codes should only be reported for dates of service for which the CPT code is valid. CPT codes 11400 and 12031 were reported on a claim. The insurance carrier denied 12031 as bundled with 11400. According to CPT® guidelines for Excision for Benign Lesions what action should the biller take? a. Write-off 12031 as repairs are included in excisions. b. Add modifier 59 to 12031 and submit a corrected claim. c. Add modifier 51 to 12031 and submit a corrected claim. d. Appeal the claim. - correct answer d. Appeal the claim. Response Feedback: According to the CPT guidelines, intermediate and complex repairs may be reported separately, in addition to, an excision. CPT® code 12031 is for an intermediate repair. The biller should appeal the decision. What is one way to assist in lowering denials for non-covered services? a. Keep every payer policy on file b. Call insurance companies after any services are rendered c. Be aware of the most common exclusions in the office's major plans d. Appeal all non-covered service denials - correct answer c. Be aware of the most common exclusions in the office's major plans Response Feedback: AAPC CPB - Chapter 13 Review Test Questions and Answers 2024. A biller cannot be expected to know every exclusion that each plan carries, but should be aware of the most common exclusions in the major plans that their office contracts with to ensure avoidance of this issue, when possible. Appeals for non-covered services are futile.