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Exam (elaborations)

CPB Practice Exam A Questions and Answers (100% Pass)

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CPB Practice Exam A Questions and Answers (100% Pass) 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 ...

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  • August 29, 2024
  • 15
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
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©SOPHIABENNET@2024-2025 Thursday, August 22, 2024 10:21 AM




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CPB Practice Exam A Questions and
Answers (100% Pass)

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? - 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)? -
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.



1

, ©SOPHIABENNET@2024-2025 Thursday, August 22, 2024 10:21 AM




Certified Professional Biller By: American Academy of Professional Coders(AAPC)


Based on the remittance advice and the payment policy provided, what
action is required for this claim? - 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? - 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




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