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AAPC Certified Professional Biller (CPB) Sample Questions:

1. DOD

A) Disproportionate share hospital (adjustment)
B) Diagnosis related groups
C) Department of Defense
D) Diagnostic and statistical manual

2. What is All Patient DiagnosisRelated Group (APDRG)?

A) DRG system adapted for use by third-party payers to reimburse hospitals for inpatient care provided to nonMedicare beneficiaries (e.g. Blue Cross BlueShield, commercial health plans, TRICARE); DRG assignment is based on intensity of resources.
B) Adopted by Medicare in 2008 to reimburse hospitals for inpatient care provided to Medicare beneficiaries; expanded original DRG system (based on intensity of resources) to add two subclasses to each DRG that adjusts Medicare inpatient hospital reimbursement rates for severity of illness (SOI) (extent of physiological decompensation or organ system loss of function) and risk of mortality (ROM) (likelihood of dying); each subclass, in turn, is subdivided into four areas: (1) minor, (2) moderate, (3) major, (4) extreme.

3. What should be done if an insurance company incorrectly denies a covered service?

A) Resubmit the same claim without changes
B) Bill the patient immediately
C) File an appeal with supporting documentation
D) Write off the charge

4. Preauthorization is an authorization that must be received from a payer before treatment by a specialist will be covered.

A) FALSE
B) TRUE

5. What does it mean by angi?

A) vessel
B) vein
C) artery

Solutions: