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AAPC CPB FINAL EXAM NEWEST 2025 ACTUAL
EXAM COMPLETE 250 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) |ALREADY GRADED A+|BRAND
NEW!!
When a patient is seen for evaluation and the decision is made for a minor procedure that is performed on the same day, which modifier is appended to the claim to allow reimbursement for the E/M and the procedure? - ANSWER-25
A 68-year-old Medicare patient presented for an annual examination and had no complaints. Her claim, billed as 99387, was denied. Was this billed correctly? If not, how is this encounter correctly billed? - ANSWER-it depends on doc
If a procedure is performed on a 72-year-old Medicare patient which code category is preferred for reporting? - ANSWER-G code HCPCS
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The NCCI policy manual is updated: - ANSWER-annually
The part of National Correct Coding Initiative (NCCI) that places frequency limitations on codes that can be billed on a
single date of service by a single provider is called: - ANSWER-
MUE
provide limitations of frequency on codes that can be billed in a single day by a single provider for a beneficiary. - ANSWER- MUE
NCCI edits are updated by CMS and released - ANSWER- quarterly
When using the Practitioner PTP Edits table, an NCCI tool, the
modifier indicator of 0 (zero) tells the user: - ANSWER-mod not
allowed
Indicates specific CPT code pairs that can be reported on the same day for the same beneficiary by the same provider. - ANSWER-NCCI file
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The Medicaid NCCI program consists of six methodologies.Each methodology is composed of ___ components - ANSWER- 4
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: - ANSWER-fraud
When looking at the NCCI Edit tables, Column 1 codes are
indicated as payable. Column 2 codes contain the codes that are:
- ANSWER-not payable without mod
What modifier is required when a procedure is performed on the same day as an E/M service and both should be paid and not considered bundled? - ANSWER-25
What modifier is used to indicate two procedures are performed on the same day and should not be bundled? - ANSWER-59
NCDs are released by which of the following entities: -
ANSWER-CMS
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Reporting a service based on an LCD requires the CPB to look at coverage guidance for the procedure being performed.
Coverage guidance would NOT include: - ANSWER-
experimental procedures
Which of the following modifiers are not used to bypass NCCI edits? - ANSWER-76, 77
When applying an LCD to services, which of the following statements is TRUE regarding the CPT® and ICD-10-CM codes reported on a claim form? - ANSWER-Documentation should provide medical necessity and support the CPT and ICD-10-CM codes reported
Codes that are considered to be bundled are based on Centers for
Medicare & Medicaid (CMS) standards called: - ANSWER-
NCCI
An E/M service that is performed during a post-operative period, but is not related to the surgical procedure that was performed, can be billed with which modifier? - ANSWER-24
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