PTCB exam 2020 Questions and
Answers Rated A
(CPT billing codes 99605, 99606, and 99607) Correct Answer-Medication Therapy Management (MTM)
(CPT billing codes 99211-99215) Correct Answer-Incident-to
(CPT codes 99496
...
PTCB exam 2020 Questions and
Answers Rated A
(CPT billing codes 99605, 99606, and 99607) Correct Answer-Medication Therapy Management (MTM)
(CPT billing codes 99211-99215) Correct Answer-Incident-to
(CPT codes 99496 and 99495) Correct Answer-Transitional care management (TCM)
(CPT codes G0438 and G0439) Correct Answer-CMS annual wellness visit (AWV)
(CPT codes 99490) Correct Answer-Incident-to physician: Chronic care management
(CPT codes 99487 and 99489)I Correct Answer-ncident-to physician: Complex chronic care management
(CPT codes G0108 and G0109) Correct Answer-Diabetes self-management training
(CPT codes 98960, 98961, and 98962) Correct Answer-Diabetes education
(APC code 5012 with HCPCS code G0463) Correct Answer-Office visit in a hospital-based clinic (Hospital
outpatient)
(CPT codes 99211-99215) Correct Answer-The majority of options for pharmacist revenue generation
are through the Evaluation and Management (E&M)
Prior Authorization Correct Answer-the need to obtain permission from the insurance company before
seeking certain types of services
There are several kinds of medications that may require prior authorization: Correct Answer-1- A brand
name medication that is available as a generic
2- An expensive medication
3- A medication used for cosmetic reasons (such as those for hair growth and wrinkle treatment)
4- A medication prescribed at higher doses than normal
5- A medication that treats non-life threatening conditions
6- A medication not usually covered by the insurance company, but deemed medically necessary by the
physician
Steps for Prior Authorization: Correct Answer-Step 1: The pharmacy contacts the physician who
prescribed the medication to see if he or she obtained prior authorization from the insurance company
when the drug was prescribed.
Step 2: If not, the physician will contact the insurance company and submit a formal authorization
request.
Step 3: The insurance provider may have the patient complete and sign forms.
Step 4: The insurance company will alert the pharmacy once they have approved the prescription or
denied the request.
PHARMACY CLAIM REJECTIONS AND FIXES Correct Answer-1- No PCN (Processor Control Number) on
the claim. To fix this error, you must find the PCN from the patient's insurance card or insurance
company and then edit the claim before resubmitting. You may need to contact the insurance company
to get more information on the problem.
2- No Group Number on the claim. To fix the problem
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