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AAPC Certified Professional Biller (CPB) Sample Questions:

1. What is the primary purpose of National Correct Coding Initiative (NCCI) edits?

A) Set reimbursement rates
B) Identify unbundling and improper coding
C) Replace CPT guidelines
D) Increase claim approvals

2. GEP stands for General Enrollment Period.

A) TRUE
B) FALSE

3. What is Allowed Charge?

A) The Minimum amount the payer will reimburse for each procedure or service, according to the patients policy.
B) The Maximum amount the payer will reimburse for each procedure or service, according to the patients policy.
C) The amount the payer will reimburse for each procedure or service, according to the patients policy.

4. Case management is development of patient care plans to coordinate and provide care for complicated cases in a cost effective manner.

A) TRUE
B) FALSE

5. Which payer typically requires prior authorization for certain services?

A) All payers equally
B) Only Medicare
C) Commercial and managed care plans
D) Medicaid only

Solutions: