AAPC CPB Practice Exam With
Verified Questions & Answers 2024 (GRADED
A+)
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 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 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 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 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 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
Verified Questions & Answers 2024 (GRADED
A+)
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 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 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 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 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 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
