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AAPC Certified Professional Biller (CPB) Sample Questions:

1. Which part of the body does genit refer to?

A) stomach
B) genitals
C) intestine
D) tongue

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

A) FALSE
B) TRUE

3. A patient has Medicare as primary and a commercial plan as secondary. Which insurance should be billed first?

A) Secondary insurance
B) Medicaid
C) Commercial insurance
D) Medicare

4. What does BC stand for?

A) Blue Cross
B) Black Cross
C) Beneficiary Association
D) Beneficiary Counseling

5. Allowable Charge

A) DRG system adapted for use by thirdparty payers to reimburse hospitals for inpatient care provided to nonMedicare beneficiaries (e.g. Blue Cross Blue Shield, commercial health plans, TRICARE); DRG assignment is based on intensity of resources.
B) The Maximum amount the payer will reimburse for each procedure or service, according to the patients policy.
C) See limiting charge; maximum fee a physician may charge.
D) 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 of mortality (ROM) (likelihood of dying); each subclass, in turn, is subdivided into four areas: (1) minor, (2) moderate, (3) major, (4) extreme.

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