CPB PRACTICE EXAM QUESTIONS &
ANSWERS 2024 ACTUAL EXAM 120
QUESTIONS & CORRECT DETAILED
ANSWERS. GRADED A+
3. Private companies contract with cms to administer:
A) medicare part a & b
B) medicare part b
C) medicare part c
D) medicare part a, b, & c - ansd) medicare part a, b, and c
Rationale: medicare part a, b, and c are all administered by private companies that
contract with cms as medicare administrative contractors or macs.
A 16-year-old patient is seen for an evaluation of left ankle pain. He has been a patient
of dr. Smith's since infancy and dr. Smith always performs the patient's annual sports
physical exam. During this visit the physician performs a problem focused history,
expanded problem focused exam, and medical decision making is of low complexity.
Using the office equipment, a 2-view x-ray is taken of the left ankle which shows normal
skeletal structures, no fractures identified. The cpt codes for this encounter would be?
A) 99202, 73590-lt
B) 99213, 73590-lt
C) 99213, 73600-lt
D) 99212, 73610-lt - ansc) 99213, 73600-lt
A claim has been processed by the payer, payment received and posted to the patient's
account. What is the next step in the billing process?
A) no further steps need to be taken
B) a receipt of payment is sent to the payer.
C) patient is notified at 60 days of any remaining patient responsibility
D) a statement is sent notifying the patient of their remaining responsibility - ansd) a
statement is sent notifying the patient of their remaining responsibiity
Rationale: the final step in the billing process is to inform the patient of the remaining
portion due for the services they received. The statement should reflect the amount paid
by the insurance, any adjustments made, and the final amount due from the patient.
The statement should also include the date the payment is due from the patient.
, A medicare patient has been treated for four (4) diagnoses during his last visit:
hypertension, type 2 diabetesl osteoarthritis, & ckd. How many diagnoses can be
reported in box 24e (diagnosis code pointer) cms-1500 claim form for each service
provided for this patient?
A) one
B) two
C) three
D) four - ansa) one
Rationale: medicare requires that only one diagnosis be reported for each service
provided. Commerical payers may or may not have this same requirement
A medicare patient is seen on may 1, 2017 and the claim is submitted for this visit on
may 5, 2018. What will be the expected outcome for payment of this claim?
A) medicare will reimburse at a 40% reduction based on timely filing regulations
B) medicare will require an addendum explaining the reason for the delayed claim
submission
C) medicare will deny the claim based on timely filing rule
D) medicare will pay the claim for provided services. - ansc) medicare will deny the
claim based on timely filing rule.
Rationale: medicare requires all claims for services be billed within one year of the date
of service. Any claims received after the one year date will be denied due to the timely
filing statute.
A patient by the name of charles daniel johnson lists his name as danny johnson when
he completes his patient demographic sheet. His insurance card lists his name as c.
Daniel johnson. How should his name be listed when entering his demographic
information into the billing system?
A) his full given name, charles daniel johnson
B) the name he "goes by". Danny johnson
C) danield johnson as listed on his insurance card
D) charlie daniel johnson - ansc) daniel johnson as listed on his insurance card
Rationale: claims should be submitted using the name that is listed on the insurance
card to prevent denials for incorrect policyholder information
A patient is seen in the provider's office for a follow-up visit eight days after a procedure.
The procedure has a global period of 90 days. The provider submits an e/m code based
on documentation of the follow-up visit. The claim is submitted and denied. What is the
next step for the biller?
ANSWERS 2024 ACTUAL EXAM 120
QUESTIONS & CORRECT DETAILED
ANSWERS. GRADED A+
3. Private companies contract with cms to administer:
A) medicare part a & b
B) medicare part b
C) medicare part c
D) medicare part a, b, & c - ansd) medicare part a, b, and c
Rationale: medicare part a, b, and c are all administered by private companies that
contract with cms as medicare administrative contractors or macs.
A 16-year-old patient is seen for an evaluation of left ankle pain. He has been a patient
of dr. Smith's since infancy and dr. Smith always performs the patient's annual sports
physical exam. During this visit the physician performs a problem focused history,
expanded problem focused exam, and medical decision making is of low complexity.
Using the office equipment, a 2-view x-ray is taken of the left ankle which shows normal
skeletal structures, no fractures identified. The cpt codes for this encounter would be?
A) 99202, 73590-lt
B) 99213, 73590-lt
C) 99213, 73600-lt
D) 99212, 73610-lt - ansc) 99213, 73600-lt
A claim has been processed by the payer, payment received and posted to the patient's
account. What is the next step in the billing process?
A) no further steps need to be taken
B) a receipt of payment is sent to the payer.
C) patient is notified at 60 days of any remaining patient responsibility
D) a statement is sent notifying the patient of their remaining responsibility - ansd) a
statement is sent notifying the patient of their remaining responsibiity
Rationale: the final step in the billing process is to inform the patient of the remaining
portion due for the services they received. The statement should reflect the amount paid
by the insurance, any adjustments made, and the final amount due from the patient.
The statement should also include the date the payment is due from the patient.
, A medicare patient has been treated for four (4) diagnoses during his last visit:
hypertension, type 2 diabetesl osteoarthritis, & ckd. How many diagnoses can be
reported in box 24e (diagnosis code pointer) cms-1500 claim form for each service
provided for this patient?
A) one
B) two
C) three
D) four - ansa) one
Rationale: medicare requires that only one diagnosis be reported for each service
provided. Commerical payers may or may not have this same requirement
A medicare patient is seen on may 1, 2017 and the claim is submitted for this visit on
may 5, 2018. What will be the expected outcome for payment of this claim?
A) medicare will reimburse at a 40% reduction based on timely filing regulations
B) medicare will require an addendum explaining the reason for the delayed claim
submission
C) medicare will deny the claim based on timely filing rule
D) medicare will pay the claim for provided services. - ansc) medicare will deny the
claim based on timely filing rule.
Rationale: medicare requires all claims for services be billed within one year of the date
of service. Any claims received after the one year date will be denied due to the timely
filing statute.
A patient by the name of charles daniel johnson lists his name as danny johnson when
he completes his patient demographic sheet. His insurance card lists his name as c.
Daniel johnson. How should his name be listed when entering his demographic
information into the billing system?
A) his full given name, charles daniel johnson
B) the name he "goes by". Danny johnson
C) danield johnson as listed on his insurance card
D) charlie daniel johnson - ansc) daniel johnson as listed on his insurance card
Rationale: claims should be submitted using the name that is listed on the insurance
card to prevent denials for incorrect policyholder information
A patient is seen in the provider's office for a follow-up visit eight days after a procedure.
The procedure has a global period of 90 days. The provider submits an e/m code based
on documentation of the follow-up visit. The claim is submitted and denied. What is the
next step for the biller?
