AAPC CPB Exam Newest / AAPC CPB Preparation / AAPC CPB Practice Exam
AAPC CPB EXAM NEWEST / AAPC CPB PREPARATION / AAPC
CPB PRACTICE EXAM WITH 400 COMPLETE QUESTIONS AND
CORRECT ANSWERS |ALREADY GRADED A+||BRAND NEW
VERSIONS
When a patient has Medicare primary and AARP as Medigap, what is entered on
the CMS-1500 claim form in item 9d for the Insurance Plan Name or Program
Name for Medicare to cross over the claim?
A. Plan name followed by "MEDIGAP"
B. Plan Payer ID followed by "MEDIGAP"
C. COBA Medigap claim-based identifier (ID)
D. Leave blank - Correct Answer-C. COBA Medigap claim-based identifier (ID)
Which guidelines must all billing personnel be knowledgeable about in order to
ensure compliance with Medicaid programs?
A. Federal guidelines
B. State guidelines
C. Both A and B
D. None - Correct Answer-C. Both A and B
Which of the following services is covered by Early and Periodic Screening,
Diagnostic, and Treatment (EPSDT)?
1|Page
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A. Family planning
B. Obstetric care
C. Pediatric checkups
D. Emergency department visits - Correct Answer-C. Pediatric checkups
A female patient who was involved in an auto accident presents to the emergency
department (ED) for evaluation. She does not have any complaints. The provider
evaluates her and determines there are no injuries. The provider informs the
patient to come back to the ED or see her primary care physician if she develops
any symptoms. How is the claim processed for this encounter?
A. The medical insurance is billed primary and the auto insurance is billed
secondary.
B. The auto insurance is billed primary and the medical insurance is billed
secondary.
C. Bill the medical insurance first to receive a denial and then submit with the
remittance advice to the auto insurance.
D. Bill only the medical insurance because the auto insurance only covers damage
to the vehicle, not medical expenses. - Correct Answer-B. The auto insurance is
billed primary and the medical insurance is billed secondary.
What forms need to be submitted when billing for a work-related injury?
A. Progress reports, and WC-1500 claim form
B. UB-04
C. First Report of Injury form and an itemized statement
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D. First Report of Injury form, progress reports, and CMS-1500 claim form -
Correct Answer-D. First Report of Injury form, progress reports, and CMS-1500
claim form
A document provided to Medicare patients explaining their financial responsibility
if Medicare denies a service is a(n):
A. Notice of Financial Liability
B. Advance Beneficiary Notice
C. Insurance waiver
D. Explanation of Benefits - Correct Answer-B. Advance Beneficiary Notice
What is an Accountable Care Organization (ACO)?
A. Groups of doctors, hospitals, and other health care providers who coordinate
high quality care to Medicare patients.
B. An insurance carrier that provides a set fee based on the diagnosis of the
patient.
C. A group of providers who contract with a third party administrator to pay fee
for service for services.
D. Hospitals who see a subset of patients for cost efficiency. - Correct Answer-A.
Groups of doctors, hospitals, and other health care providers who coordinate high
quality care to Medicare patients.
A new patient presents for her annual exam and has no complaints. She is
scheduled to see the physician assistant (PA). How should services be billed ?
3|Page
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A. Bill under the PA.
B. A new patient can be billed incident to the physician.
C. The PA cannot see new patients.
D. Reschedule the patient with the physician - Correct Answer-A. Bill under the PA.
CPT® codes 12032 and 12001 were reported together for a 2.6 cm intermediate
repair of a laceration to the right arm and a 2.5 cm simple repair of a laceration to
the left arm. 12001 was denied as a bundled service. What action should be taken
by the biller (following the CPT® guidelines)?
A. Write-off the charge for 12001 as it is a bundled procedure.
B. Resubmit a corrected claim as 12032, 12001-59.
C. Transfer the charge to patient responsibility.
D. Resubmit a corrected claim as 12032, 12001-51. - Correct Answer-B. Resubmit a
corrected claim as 12032, 12001-59.
According to CMS, which of the following services are included in the global
package for surgical procedures?
I. Surgical procedure performed
II. E/M visits unrelated to the diagnosis for which the surgical procedure is
performed
III. Local infiltration, digital block, or topical anesthesia
4|Page
AAPC CPB EXAM NEWEST / AAPC CPB PREPARATION / AAPC
CPB PRACTICE EXAM WITH 400 COMPLETE QUESTIONS AND
CORRECT ANSWERS |ALREADY GRADED A+||BRAND NEW
VERSIONS
When a patient has Medicare primary and AARP as Medigap, what is entered on
the CMS-1500 claim form in item 9d for the Insurance Plan Name or Program
Name for Medicare to cross over the claim?
A. Plan name followed by "MEDIGAP"
B. Plan Payer ID followed by "MEDIGAP"
C. COBA Medigap claim-based identifier (ID)
D. Leave blank - Correct Answer-C. COBA Medigap claim-based identifier (ID)
Which guidelines must all billing personnel be knowledgeable about in order to
ensure compliance with Medicaid programs?
A. Federal guidelines
B. State guidelines
C. Both A and B
D. None - Correct Answer-C. Both A and B
Which of the following services is covered by Early and Periodic Screening,
Diagnostic, and Treatment (EPSDT)?
1|Page
, AAPC CPB Exam Newest / AAPC CPB Preparation / AAPC CPB Practice Exam
A. Family planning
B. Obstetric care
C. Pediatric checkups
D. Emergency department visits - Correct Answer-C. Pediatric checkups
A female patient who was involved in an auto accident presents to the emergency
department (ED) for evaluation. She does not have any complaints. The provider
evaluates her and determines there are no injuries. The provider informs the
patient to come back to the ED or see her primary care physician if she develops
any symptoms. How is the claim processed for this encounter?
A. The medical insurance is billed primary and the auto insurance is billed
secondary.
B. The auto insurance is billed primary and the medical insurance is billed
secondary.
C. Bill the medical insurance first to receive a denial and then submit with the
remittance advice to the auto insurance.
D. Bill only the medical insurance because the auto insurance only covers damage
to the vehicle, not medical expenses. - Correct Answer-B. The auto insurance is
billed primary and the medical insurance is billed secondary.
What forms need to be submitted when billing for a work-related injury?
A. Progress reports, and WC-1500 claim form
B. UB-04
C. First Report of Injury form and an itemized statement
2|Page
, AAPC CPB Exam Newest / AAPC CPB Preparation / AAPC CPB Practice Exam
D. First Report of Injury form, progress reports, and CMS-1500 claim form -
Correct Answer-D. First Report of Injury form, progress reports, and CMS-1500
claim form
A document provided to Medicare patients explaining their financial responsibility
if Medicare denies a service is a(n):
A. Notice of Financial Liability
B. Advance Beneficiary Notice
C. Insurance waiver
D. Explanation of Benefits - Correct Answer-B. Advance Beneficiary Notice
What is an Accountable Care Organization (ACO)?
A. Groups of doctors, hospitals, and other health care providers who coordinate
high quality care to Medicare patients.
B. An insurance carrier that provides a set fee based on the diagnosis of the
patient.
C. A group of providers who contract with a third party administrator to pay fee
for service for services.
D. Hospitals who see a subset of patients for cost efficiency. - Correct Answer-A.
Groups of doctors, hospitals, and other health care providers who coordinate high
quality care to Medicare patients.
A new patient presents for her annual exam and has no complaints. She is
scheduled to see the physician assistant (PA). How should services be billed ?
3|Page
, AAPC CPB Exam Newest / AAPC CPB Preparation / AAPC CPB Practice Exam
A. Bill under the PA.
B. A new patient can be billed incident to the physician.
C. The PA cannot see new patients.
D. Reschedule the patient with the physician - Correct Answer-A. Bill under the PA.
CPT® codes 12032 and 12001 were reported together for a 2.6 cm intermediate
repair of a laceration to the right arm and a 2.5 cm simple repair of a laceration to
the left arm. 12001 was denied as a bundled service. What action should be taken
by the biller (following the CPT® guidelines)?
A. Write-off the charge for 12001 as it is a bundled procedure.
B. Resubmit a corrected claim as 12032, 12001-59.
C. Transfer the charge to patient responsibility.
D. Resubmit a corrected claim as 12032, 12001-51. - Correct Answer-B. Resubmit a
corrected claim as 12032, 12001-59.
According to CMS, which of the following services are included in the global
package for surgical procedures?
I. Surgical procedure performed
II. E/M visits unrelated to the diagnosis for which the surgical procedure is
performed
III. Local infiltration, digital block, or topical anesthesia
4|Page
