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| Section | Objectives |
|---|
| Coding and Claim Submission Basics | - Use of modifiers and coding compliance - ICD-10-CM, CPT, and HCPCS overview - Claims submission processes
|
| Insurance Processing and Payer Rules | - Coordination of benefits (COB) - Medicare and Medicaid guidelines - Private insurance policies and contracts
|
| Revenue Cycle Management | - Claims denial and rejection management - Payment posting and reconciliation - Accounts receivable follow-up
|
| Compliance and Regulations | - Billing compliance standards - HIPAA and patient privacy rules - Fraud and abuse prevention
|
| Medical Billing Fundamentals | - Medical billing workflow and revenue cycle - Healthcare reimbursement systems - Insurance types and payer structures
|
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AAPC Certified Professional Biller (CPB) Sample Questions (Q84-Q89):
NEW QUESTION # 84
Current Procedural Terminology (CPT) is used to report professional services to payers.
Answer: B
NEW QUESTION # 85
Case manager submits written confirmation, authorizing treatment, to provider.
Answer: B
NEW QUESTION # 86
ABN stands for Advance Beneficiary Notice.
Answer: B
NEW QUESTION # 87
What are Category I Codes?
- A. Procedures/ services identified by a five digit CPT code and descriptor nomenclature; these codes are traditionally associated with CPT and organized within six sections.
- B. Optional performance measurement tracking codes that are assigned an alphanumeric identifier with a letter in the last field (e,g.,1234A); these codes will be located after the medicine section; their use is optional.
- C. Temporary codes for data collection purposes that are assigned an alphanumeric identifier with a letter in the last field (e.g., 0001T) these codes are located after the Medicine section, and will be archived after five years unless accepted for placement within Category I sections of CPT.
Answer: A
NEW QUESTION # 88
Which term means the patient is not responsible for paying for what the insurance plan denies?
- A. Health Insurance Claim
- B. Hold Harmless Clause
- C. Centers of Medicare and Medicaid Services150 (CMS1500)
- D. Explanation of Benefits
Answer: B
NEW QUESTION # 89
......
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