AAPC CPB - Chapter 7 Review Questions

AAPC CPB - Chapter 7 Review | Questions and Correct Solutions Latest Update

MUE is the acronym for:

• Medicare Unlikely Edits
• Medically Unnecessary Edits
• Medicare Unnecessary Edits
• Medically Unlikely Edits - Answer - d. Medically Unlikely Edits

Based on NCCI edits, when a procedure is bundled and has a CCM indicator of 0 - which of the following Modifiers is allowed?

• 51
• 59
• 25
• Modifiers are not allowed - Answer - d. Modifiers are not allowed

Which of the following is considered to be an anatomic modifier?

• 77
• LD
• T5
• Both B and C - Answer - d. Both B and C

Medicare states that reporting bundled codes in addition to the major procedural code is considered to

be unbundling, and if repeated with frequency it is considered to be:

• Abuse 1 / 2

• Fraud
• Misrepresentation
• False Claims - Answer - b. Fraud

A patient is scheduled for a laparoscopic procedure that is converted to an open procedure after the procedure is initiated. Which of the following would be correct coding based on CMS NCCI edits?

• Bill both procedures.
• Bill only the laparoscopic procedure since that is what was scheduled.
• Bill only the open procedure (most extensive).
• Bill both procedures with a modifier appended to the Column 2 code. - Answer - c. Bill only the open

procedure (most extensive).

NCCI is the acronym for:

• National Correct Coding Institute
• National Correct Coding Initiative
• National Coding Clinic Initiative
• National Coding Coverage Institute - Answer - b. National Correct Coding Initiative

Services that are integral to the procedure being performed - such as cleaning and prepping the skin, opening and closing the surgical site, or any cultures being taken are considered:

• Separately billable.
• Are separately billable if they require additional time.
• Are included and never separately billable.
• Individually by payer. - Answer - c. Are included and never separately billable.

Modifier 59 is used to unbundle procedures with an indicator of 1. Under what circumstances would modifier 59 NOT be appropriate?

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