CPPM/AAPC EXAM QUESTIONS AND ANSWERS
LATEST UPDATE (GRADED A+)
You work for. a pediatric office and the parents of a patient inform you they can No longer afford
halter insurance. They do not qualify for Medicaid as their income is too high. What would you
recommend?
Apply for CHIP coverage
Procedure codes are reported by the facility using which code set?
ICD-10-PCS - Inpatient Hospital Facilities. Only submitted by FACILITIES!
Posting payment and collection policies in a prominent place in your office has what benefit?
Prepares the patient to make proper payments at the time of service.
There are many elements to a successful appeals process. What is the first and most important
process?
Analyze the reason for the denial.
Which of the following services is covered by Medicare Part B?
Physician services
Which services meet medical necessity?
A lipid panel for a patient with high cholesterol
A claim form that is complete and accurate and includes all provider information, member
information and other additional information needed to process for payment is called?
A clean Claim
The Place of Service (POS) code on a claim form is important to determine correct reimbursement.
Which statement is correct?
The professional component for services provided in a facility (for example, hospital or ASC) are less
than when provided in the physicians office because the physician does not have any practice expense
at the facility like rent, staff, and supplies.
When reviewing denials, your biller notices that one fo the private payers is not paying for
venipuncture when performed during an office visit. What should be done?
Check the payer contract to see if the denial is appropriate
In which kind of a scenario is Medicare the secondary payer?
LATEST UPDATE (GRADED A+)
You work for. a pediatric office and the parents of a patient inform you they can No longer afford
halter insurance. They do not qualify for Medicaid as their income is too high. What would you
recommend?
Apply for CHIP coverage
Procedure codes are reported by the facility using which code set?
ICD-10-PCS - Inpatient Hospital Facilities. Only submitted by FACILITIES!
Posting payment and collection policies in a prominent place in your office has what benefit?
Prepares the patient to make proper payments at the time of service.
There are many elements to a successful appeals process. What is the first and most important
process?
Analyze the reason for the denial.
Which of the following services is covered by Medicare Part B?
Physician services
Which services meet medical necessity?
A lipid panel for a patient with high cholesterol
A claim form that is complete and accurate and includes all provider information, member
information and other additional information needed to process for payment is called?
A clean Claim
The Place of Service (POS) code on a claim form is important to determine correct reimbursement.
Which statement is correct?
The professional component for services provided in a facility (for example, hospital or ASC) are less
than when provided in the physicians office because the physician does not have any practice expense
at the facility like rent, staff, and supplies.
When reviewing denials, your biller notices that one fo the private payers is not paying for
venipuncture when performed during an office visit. What should be done?
Check the payer contract to see if the denial is appropriate
In which kind of a scenario is Medicare the secondary payer?
