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NHA BILLING AND CODING SPECIALIST EXAM NEWEST 2026
ACTUAL EXAM WITH COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (100% VERIFIED ANSWERS) |ALREADY
GRADED A+| ||PROFESSOR VERIFIED||
1. A billing and coding specialist is reviewing an encounter note
that indicates a biopsy was performed. This requires which of the
following additional details to fully code this procedure? -
ANSWER-a. Benign vs. malignant status
1. A billing and coding specialist is preparing a claim for an
established patient who arrived for an annual exam. During the
examination, the provider treated the patient's sinus infection and
prescribed medication for it. Which of the following Evaluation and
Management (E/M) codes requires modifier -52? - ANSWER-a.
99213
1. A billing and coding specialist is determining third-party
responsibility for a 70-year-old who has Medicare coverage. The
Patient's spouse has insurance with Blue Cross Blue Shield
through their employer. Which of the following actions should the
specialist take? - ANSWER-a. Establish coordination of benefits
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1. Which of the following actions showing a billing and coding
specialist take to assign a diagnosis code to the highest level of
specificity? - ANSWER-a. Apply characters four through seven to
the claim
1. A billing and coding specialist is reviewing a claim that was
denied for services provided during the postoperative period. The
patient was diagnosed with pneumonia during a postoperative
encounter for a knee joint replacement 2 weeks ago. Which of the
following modifiers should the specialist add the claim prior to
resubmitting? - ANSWER--24
1. A billing and coding specialist is determining the level of service
for an office visit for a new patient. Which of the following codes
represent a detailed history and detailed exam with moderate
decision-making? - ANSWER-a. 99204
1. A billing and coding specialist is submitting a claim for a school-
age child who was brought to the clinic by the maternal
grandmother. The child's parents are divorced and remarried, and
the child's mother has legal custody of the child. The specialist
should recognize that the child's primary insurance coverage is
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provided through which of the following insured individuals? -
ANSWER-a. Biological mother
1. A new patient presents for an urgent care encounter. Which of
the following code sets should be used to report this encounter? -
ANSWER-a. Office or other outpatient services
1. Which of the following should a billing and coding specialist
complete to be reimbursed for a provider's outpatient services? -
ANSWER-a. CMS-1500 claim form
1. A billing and coding specialist discovers suspicious activity that
may be fraudulent in the workplace. Which of the following actions
should the specialist take? - ANSWER-a. Call the U.S.
Department of Health and Human Services' (DHHS) anonymous
hotline.
1. Z codes are used to identify which of the following ? -
ANSWER-a. Immunization
NHA BILLING AND CODING SPECIALIST EXAM NEWEST 2026
ACTUAL EXAM WITH COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (100% VERIFIED ANSWERS) |ALREADY
GRADED A+| ||PROFESSOR VERIFIED||
1. A billing and coding specialist is reviewing an encounter note
that indicates a biopsy was performed. This requires which of the
following additional details to fully code this procedure? -
ANSWER-a. Benign vs. malignant status
1. A billing and coding specialist is preparing a claim for an
established patient who arrived for an annual exam. During the
examination, the provider treated the patient's sinus infection and
prescribed medication for it. Which of the following Evaluation and
Management (E/M) codes requires modifier -52? - ANSWER-a.
99213
1. A billing and coding specialist is determining third-party
responsibility for a 70-year-old who has Medicare coverage. The
Patient's spouse has insurance with Blue Cross Blue Shield
through their employer. Which of the following actions should the
specialist take? - ANSWER-a. Establish coordination of benefits
,2|Page
1. Which of the following actions showing a billing and coding
specialist take to assign a diagnosis code to the highest level of
specificity? - ANSWER-a. Apply characters four through seven to
the claim
1. A billing and coding specialist is reviewing a claim that was
denied for services provided during the postoperative period. The
patient was diagnosed with pneumonia during a postoperative
encounter for a knee joint replacement 2 weeks ago. Which of the
following modifiers should the specialist add the claim prior to
resubmitting? - ANSWER--24
1. A billing and coding specialist is determining the level of service
for an office visit for a new patient. Which of the following codes
represent a detailed history and detailed exam with moderate
decision-making? - ANSWER-a. 99204
1. A billing and coding specialist is submitting a claim for a school-
age child who was brought to the clinic by the maternal
grandmother. The child's parents are divorced and remarried, and
the child's mother has legal custody of the child. The specialist
should recognize that the child's primary insurance coverage is
, 3|Page
provided through which of the following insured individuals? -
ANSWER-a. Biological mother
1. A new patient presents for an urgent care encounter. Which of
the following code sets should be used to report this encounter? -
ANSWER-a. Office or other outpatient services
1. Which of the following should a billing and coding specialist
complete to be reimbursed for a provider's outpatient services? -
ANSWER-a. CMS-1500 claim form
1. A billing and coding specialist discovers suspicious activity that
may be fraudulent in the workplace. Which of the following actions
should the specialist take? - ANSWER-a. Call the U.S.
Department of Health and Human Services' (DHHS) anonymous
hotline.
1. Z codes are used to identify which of the following ? -
ANSWER-a. Immunization
