Aapc cpb chapter 9 Study guides, Class notes & Summaries

AAPC CPB Chapter 7 Review Study Exam Test 2024. Who were the NCCI edits originally developed to be used by? a. Commercial Carriers b. Medicare Administrative Contractors c. Self-pay patients d. Medicare beneficiaries - correct answer b. Medicare Administrative Contractors The NCCI edits have column 1 and Column 2 codes and provide an indicator to determine whether a modifier is allowed to be used. Which indicator is used to tell the biller a modifier is never allowed? a. 0 b. 1 c....

AAPC CPB Chapter 9 Review A patient with ABC insurance is seen on May 1st, and the claim is submitted on July 15 of the same year. Has the claim met the timely filing deadline? a. Yes. All payers have the same timely filing deadline of one year from date of service. b. No. All payers have a 30-day timely filing deadline. c. Maybe. ABC's timely filing policy should be reviewed to determine if the deadline was met. d. Maybe. Prepare an appeal letter just in case the claim is denied. ...

AAPC CPB - Chapter 9 Practical Application Questions 2024.Case 1 - Clearinghouse Rejections Report Status: 11/19/20XX Contents: C4450 - Principal Diagnosis Code must be valid; REJECTED BY SYSTEM EDI; Rejected Patient Name: Adams, David Patient Number: 384594 Payer: HEALTHSPRINGMEDICARE Submission Date: 11/19/XX Date of Service: 11/09/XX Charge: $557.00 Provider: Post, Alexis According to this clearinghouse rejections report, what actions should be taken on the claim for David Adams,...

AAPC CPB Chapter 3 ReviewWhat is a claim that is sent for reimbursement that contains all the required data elements to process the claim referred to as? a. Submitted b. Adjudicated c. Clean Claim d. Medically necessary c. Clean Claim HIPAA Section 164.508 states that covered entities may not use or disclose protected information without a valid authorization. In what circumstances can a practice NOT release protected information with a signed authorization? a. Records sent to a p...

AAPC CPB - Chapter 9 Review | Questions and Verified Solutions Latest Update A ______ indicates the location or type of service provided for an inpatient and is reported with _______. a. Revenue code; four-digit code b. Revenue code; three-digit code c. CPT code; five-digit code d. MSDRG code; three-digit code - Answer - a. Revenue code; four-digit code Which of the following documentation is NOT needed for an audit? a. Encounter form b. Medical record c. Explanation of Benefits d. C...

AAPC CPB - Chapter 9 Review Questions and answers, rated A+ A ______ indicates the location or type of service provided for an inpatient and is reported with _______. a. Revenue code; four-digit code b. Revenue code; three-digit code c. CPT code; five-digit code d. MSDRG code; three-digit code - -a. Revenue code; four-digit code Which of the following documentation is NOT needed for an audit? a. Encounter form b. Medical record c. Explanation of Benefits d. CMS-1500 claim form - -c....

AAPC CPB - Chapter 9 Questions and answers, graded A+ When a claim has been paid, an EOB is sent to: a. the clearinghouse. b. the patient. c. the provider. d. the insurance company. - -b. the patient. Cost based fee schedules are developed using which of the following: a. RBRVS methodology b. total costs of every procedure or service listed in the CPT® c. total cost of all of the procedures the physician will perform d. malpractice insurance and office operating costs - -c. total co...

AAPC CPB Chapter 11 ReviewA Medicare patient presents with an injury sustained at his part-time job. His injury status is verified by his company. After services are rendered, in what order are the claims submitted? a. The worker's compensation is primary, and Medicare is secondary b. Either may be filed first, whichever pays better c. Medicare is primary, and Worker's compensation is secondary d. The patient must pay for services and files claims himself - correct answer a. The wo...

AAPC CPB - Chapter 9 Review Study Guide Quiz 2024. A ______ indicates the location or type of service provided for an inpatient and is reported with _______. a. Revenue code; four-digit code b. Revenue code; three-digit code c. CPT code; five-digit code d. MSDRG code; three-digit code -ANSWER a. Revenue code; four-digit code Which of the following documentation is NOT needed for an audit? a. Encounter form b. Medical record c. Explanation of Benefits d. CMS-1500 claim form -ANSWE...

AAPC CPB - Chapter 8 ReviewWhich statement is TRUE regarding condition codes for the UB-04 claim form? Selected Answer: d. a. A condition code identified the department for the revenue of the procedure. b. Condition codes are listed in the order of occurrence instead of numerical order. c. Condition codes are reported only on the CMS-1500 claim form. d. A condition code is used to indicate an inpatient service is reported on an outpatient claim. - correct answer d. A condition code is us...