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AAPC Chapter 13 Practical Application

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AAPC Chapter 13 Practical Application

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AAPC Chapter 13 Practical Application
Use CPB Chapter 13_Case 1.pdf to answer questions 1 & 2.

What is incorrect on this claim?

I. Birth date
II. Date of service
III. CPT code(s)
IV. ICD-10-CM code
V. HCPCS code

A. II only
B. I and V
C. V only
D. There are no errors on the claim. - correct answer-A. II only

Response Feedback:

The date of service was 8/29/20XX. The Box 24 A line 3 for HCPCS code J7609 shows
8/30/20XX. Correct the date of service on the line and resubmit the claim for payment.

Based on the question above, how should the claim be corrected?

A. Correct the dates on the claim.
B. Correct the coding on the claim.
C. Correct the dates and the coding on the claim.
D. There is nothing to correct on the claim. - correct answer-A. Correct the dates on the
claim.

Response Feedback:

Correct the date of service to 8/29/20XX.

Use CPB Chapter 13_Case 2.pdf to answer the following question.

What is incorrect on this claim?

A. The claim form is missing the FECA number.
B. The claim shows the patient's condition is related to an auto accident but there no record
of that in the demographics or the medical record.
C. The ICD-10-CM code is reported incorrectly.
D. There are no errors on this claim. - correct answer-B. The claim shows the patient's
condition is related to an auto accident but there no record of that in the demographics or the
medical record.

, Response Feedback:

There is no mention of the patient's pain being related to an auto accident. Correct the claim
and resubmit.

Use CPB Chapter 13_Case 3.pdf to answer the following question.

What is incorrect on this claim?

I. Date of service
II. Date of birth
III. CPT code
IV. ICD-10-CM code
V. Insurance ID number

A. I only
B. II, III and IV
C. I and II
D. III, IV, and V - correct answer-B. II, III and IV

Response Feedback:

DOB is incorrect. The claim shows the procedure code is for an ED visit and not an office
visit. The ICD-10-CM code is also incorrect. ICD-10-CM code Z00.121 should be reported
because abnormal findings were found during the exam such as the mild thrush and diaper
rash. Review the medical record, correct the claim and resubmit for payment.

Based on the question above, what should the biller do?

A. Correct the date of birth on the claim.
B. Check the medical record and correct the coding on the claim.
C. Correct the patient's insurance information.
D. Both A and B. - correct answer-D. Both A and B.

Response Feedback:

The claim shows the procedure code is for an ED visit and not an office visit. Review the
medical record, correct the claim and resubmit for payment. Correct the date of birth.

Use CPB Chapter 13_Case 4.pdf to answer the following question.

What is incorrect on this claim?

I. Date of service
II. Birth date
III. Insured's ID number
IV. Insured's name
V. CPT code

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