CERTIFIED BILLING AND CODING SPECIALIST
CBCS OBT EXAMINATION TEST 2026
COMPLETE QUESTIONS AND SOLUTIONS
◉Implied consent . Answer: A patient presents for treatment, such as
extending an arm to allow a venipuncture to be performed.
◉Clearinghouse . Answer: Agency that converts claims into a
standardized electronic format, looks for errors, and formats them
according to HIPAA and insurance standards.
◉Individually Identifiable . Answer: Documents that identify the
person or provide enough information so that the person could be
identified.
◉De-identified Information . Answer: Information that does not
identify an individual because unique and personal characteristics have
been removed.
◉Conest . Answer: A patient's permission evidenced by signature
,◉Authorization . Answer: Permission granted by the patient or the
patient's representative to release information for reasons other than
treatment, payment, or health care operations.
◉Reimbursement . Answer: Payment for services rendered from a
third-party payer.
◉Auditing . Answer: Review of claims for accuracy and completeness.
◉Fraud . Answer: Making false statements of representations of
material facts to obtain some benefit or payment for which no
entitlement would otherwise exist
◉Upcoding . Answer: Assigning a diagnosis code at a higher level than
the documentation supports, such as coding bronchitis as pneumonia
◉Unbundling . Answer: Using multiple codes that describe different
components of a treatment instead of using a single code that describes
all steps of the procedure
◉Abuse . Answer: Practices that directly or indirectly result in
unnecessary costs to the Medicare program.
, ◉Business Associate (BA) . Answer: Individuals, groups, or
organizations, who are not members of a covered entity's workforce, that
perform functions or activities on behalf of or for a covered entity.
◉Explanation of Benefits (EOB) . Answer: Describes the services
rendered, payment covered, and benefit limits and denials
◉National Provider Identifier (NPI) . Answer: Unique 10-digit code for
providers required by HIPAA.
◉Health Maintenance Organization (HMO) . Answer: Plan that allows
patients to only go to physicians, other health care professionals, or
hospitals on a list of approved providers, except in an emergency.
◉Procedure Code . Answer: Procedure codes (ICD-9-CM volume 3 or
ICD-10-PCS), Current Procedural Terminology (CPT) codes, or the
Health Common Procedure Coding System (HCPCS) that represents the
procedure or service
◉Modifier . Answer: Additional information about types of services,
and part of valid CPT or HCPCS codes.
◉Timely Filing Requirement . Answer: Within 1 calendar year of a
claim's date of service.
CBCS OBT EXAMINATION TEST 2026
COMPLETE QUESTIONS AND SOLUTIONS
◉Implied consent . Answer: A patient presents for treatment, such as
extending an arm to allow a venipuncture to be performed.
◉Clearinghouse . Answer: Agency that converts claims into a
standardized electronic format, looks for errors, and formats them
according to HIPAA and insurance standards.
◉Individually Identifiable . Answer: Documents that identify the
person or provide enough information so that the person could be
identified.
◉De-identified Information . Answer: Information that does not
identify an individual because unique and personal characteristics have
been removed.
◉Conest . Answer: A patient's permission evidenced by signature
,◉Authorization . Answer: Permission granted by the patient or the
patient's representative to release information for reasons other than
treatment, payment, or health care operations.
◉Reimbursement . Answer: Payment for services rendered from a
third-party payer.
◉Auditing . Answer: Review of claims for accuracy and completeness.
◉Fraud . Answer: Making false statements of representations of
material facts to obtain some benefit or payment for which no
entitlement would otherwise exist
◉Upcoding . Answer: Assigning a diagnosis code at a higher level than
the documentation supports, such as coding bronchitis as pneumonia
◉Unbundling . Answer: Using multiple codes that describe different
components of a treatment instead of using a single code that describes
all steps of the procedure
◉Abuse . Answer: Practices that directly or indirectly result in
unnecessary costs to the Medicare program.
, ◉Business Associate (BA) . Answer: Individuals, groups, or
organizations, who are not members of a covered entity's workforce, that
perform functions or activities on behalf of or for a covered entity.
◉Explanation of Benefits (EOB) . Answer: Describes the services
rendered, payment covered, and benefit limits and denials
◉National Provider Identifier (NPI) . Answer: Unique 10-digit code for
providers required by HIPAA.
◉Health Maintenance Organization (HMO) . Answer: Plan that allows
patients to only go to physicians, other health care professionals, or
hospitals on a list of approved providers, except in an emergency.
◉Procedure Code . Answer: Procedure codes (ICD-9-CM volume 3 or
ICD-10-PCS), Current Procedural Terminology (CPT) codes, or the
Health Common Procedure Coding System (HCPCS) that represents the
procedure or service
◉Modifier . Answer: Additional information about types of services,
and part of valid CPT or HCPCS codes.
◉Timely Filing Requirement . Answer: Within 1 calendar year of a
claim's date of service.
