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AAPC CPB - Chapter 8 Practical Application Questions and Answers 2023, Exams of Nursing

A series of practical application questions and answers based on the information presented in chapter 8 of the aapc cpb (certified professional biller) course. The questions focus on identifying errors in claim forms and understanding the correct procedures for correcting them. Each question is accompanied by a detailed rationale explaining the correct answer and the reasoning behind it. Valuable for students preparing for the aapc cpb exam, as it provides practical examples and insights into common claim form errors and their correction.

Typology: Exams

2023/2024

Available from 11/13/2024

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AAPC CPB - Chapter 8 Practical
Application Question and answers 2023
Using the information in CPB Chapter 8 Case 1 to answer questions 1 and 2.
After review of the information provided, are there any errors on the claim form? If so,
which elements are incorrect?
I Date of birth
II Date of service
III Primary insurance policy number
IV Primary insurance group number
V Secondary insurance policy number
VI Secondary insurance group number
VII Place of service
VIII Billing provider
IX Provider signature
X Work related
a. I, III, VII, and IX
b. I and X
c. V, VII, and VI
d. There are no errors on this claim. - correct answers b. I and X
Rationale: The date of birth is not in the correct format and the birth year is incorrect.
The date of birth is shown in Item 3 on the claim form. Enter the patient's 8-digit birth
date (MM|DD|CCYY). The claim form states the injury is work related however based on
the documentation this injury was not due to work.
Using the information in CPB Chapter 8 Case 1, answer the following question.
What should be done to correct the claim?
I Correct the formatting of Item 3 on the claim.
II Add the patient's secondary insurance information on the claim.
III Enter the ordering provider's name and NPI.
IV Review the ICD-10-CM codebook and the medical record to determine the correct
diagnosis code.
V Review the medical record to verify an X-Ray was performed.
a. II and V
b. I, II, and III
c. I and IV
d. There are no errors on this claim. - correct answers c. I and IV
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AAPC CPB - Chapter 8 Practical

Application Question and answers 2023

Using the information in CPB Chapter 8 Case 1 to answer questions 1 and 2. After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect? I Date of birth II Date of service III Primary insurance policy number IV Primary insurance group number V Secondary insurance policy number VI Secondary insurance group number VII Place of service VIII Billing provider IX Provider signature X Work related a. I, III, VII, and IX b. I and X c. V, VII, and VI d. There are no errors on this claim. - correct answers b. I and X Rationale: The date of birth is not in the correct format and the birth year is incorrect. The date of birth is shown in Item 3 on the claim form. Enter the patient's 8-digit birth date (MM|DD|CCYY). The claim form states the injury is work related however based on the documentation this injury was not due to work. Using the information in CPB Chapter 8 Case 1, answer the following question. What should be done to correct the claim? I Correct the formatting of Item 3 on the claim. II Add the patient's secondary insurance information on the claim. III Enter the ordering provider's name and NPI. IV Review the ICD-10-CM codebook and the medical record to determine the correct diagnosis code. V Review the medical record to verify an X-Ray was performed. a. II and V b. I, II, and III c. I and IV d. There are no errors on this claim. - correct answers c. I and IV

Rationale: Item 3 needs to be formatted to include a zero before the month and the day so the format of the date of birth is correct and change the year to 1973 instead of 1963. Because the ICD-10-CM code is truncated, the biller will need to view the codebook to determine how many characters are needed and medical record is required to complete applying those characters. Using the information in CPB Chapter 8 Case 2 to answer question 3. After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect? 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 IX Units of service X Service Facility Location Information a. III, IV, and X b. III and VIII c. VIII, IV and X d. None of the above - correct answers b. III and VIII Rationale: All elements of the claim are correct except: III - relationship to the insured is incorrect. Spouse is checked, where self needs to be checked. VIII - the diagnosis code needs another character. When the code is referenced in the Tabular List, a 7th character icon indicates the need for a 7th character. The A for initial visit is added to the end of the code. Using the information in CPB Chapter 8 Case 3 to answer question 4. After review of the information provided, are there any errors on the claim form? If so, which elements are incorrect? I Primary Insurance II Primary insurance ID number III Relationship to the insured IV Birthdate of insured V Provider NPI VI CPT code(s) VII Modifier VIII Diagnosis code IX Units of service X Service Facility Location Information

V Secondary insurance policy number VI Secondary insurance group number VII Place of service VIII Billing provider IX Provider signature X Diagnosis code a. I and III b. I and X c. V, VII, and VI d. There are no errors on this claim. - correct answers a. I and III Rationale: The patient's date of birth is not entered on the claim. The primary insurance policy number in item 1(a) does not match what is given in the documentation for the case. Use the information in CPB Chapter 8 Case 5 to answer the following question. What should be done to correct the claim? I Complete Item 3. II Add the patient's secondary insurance information on the claim. III Enter the ordering provider's name and NPI. IV Review the ICD-10-CM codebook and the medical record to determine the correct diagnosis code. a. I b. III c. I and III d. II and IV - correct answers a. I Rationale: Item 3 needs to be completed; enter the patient's 8-digit birth date (MM|DD| CCYY).