NHA CBCS EXAM QUESTIONS WITH
ACTUAL ANSWERS ALREADY VERIFIED
BY EXPERTS 2026
Which of the following Medicare policies determines if a particular item or service is covered by
Medicare? - Ans-National Coverage Determination (NCD)
A patient's employer has not submitted a premium payment. Which of the following claim statuses
should the provider receive from the third-party payer? - Ans-Denied
A billing and coding specialist should routinely analyze which of the following to determine the
number of outstanding claims? - Ans-Aging report
Which of the following should a billing and coding specialist use to submit a claim with supporting
documents? - Ans-Claims attachment
Which of the following terms is used to communicate why a claim line item was denied or paid
differently than it was billing? - Ans-Claim adjustment codes
On a CMS-1500 claim form, which of the following information should the billing and coding
specialist enter into Block 32? - Ans-Service facility location information
A provider's office receives a subpoena requesting medical documentation from a patient's medical
record. After confirming the correct authorization, which of the following actions should the billing
and coding specialist take? - Ans-Send the medical information pertaining to the dates of service
requested
Which of the following is the deadline for Medicare claim submission? - Ans-12 months from the
date of service
Which of the following forms does a third-party payer require for physician services? - Ans-CMS-
1500
A billing and coding specialist submitted a claim to Medicare electronically. No errors were found by
,the billing software or clearinghouse. Which of the following describes this claim? - Ans-Clean claim
Which of the following qualifies as an exception to the HIPAA Privacy Rule? - Ans-Psychotherapy
notes
Which of the following would result in a claim being denied? - Ans-An italicized code used as the first
listed diagnosis
Which of the following standardized formats are used in the electronic filing of claims? - Ans-HIPAA
standard transactions
Which of the following describes a two-digit CPT code used to indicate that the provider supervised
an interpreted a radiology procedure? - Ans-Professional component
Which of the following formats are used to submit electronic claims to a third-party payer? - Ans-
837
Urine moved from the kidneys to the bladder through which of the following parts of the body? -
Ans-Ureters
As of April 1, 2014, what is the maximum number of diagnoses that can be reported on the CMS-
1500 claim form before a further claim is required? - Ans-12
Which of the following does a patient sign to allow payment of claims directly to the provider? - Ans-
Assignment of benefits
Which of the following is the primary function of the heart? - Ans-Pumping blood in the circulatory
system
Which of the following is true regarding Medicaid eligibility? - Ans-Patient eligibility is determined
monthly
The explanation of benefits states the amount billed was $80. The allowed amount is $60, and the
patient is required to pay a $20 copayment. Which of the following describes the insurance check
amount to be posted? - Ans-$40
, Which of the following provisions ensures that an insured's benefits from all insurance companies
do not exceed 100% of allowable medical expenses? - Ans-Coordination of benefits
3
ACTUAL ANSWERS ALREADY VERIFIED
BY EXPERTS 2026
Which of the following Medicare policies determines if a particular item or service is covered by
Medicare? - Ans-National Coverage Determination (NCD)
A patient's employer has not submitted a premium payment. Which of the following claim statuses
should the provider receive from the third-party payer? - Ans-Denied
A billing and coding specialist should routinely analyze which of the following to determine the
number of outstanding claims? - Ans-Aging report
Which of the following should a billing and coding specialist use to submit a claim with supporting
documents? - Ans-Claims attachment
Which of the following terms is used to communicate why a claim line item was denied or paid
differently than it was billing? - Ans-Claim adjustment codes
On a CMS-1500 claim form, which of the following information should the billing and coding
specialist enter into Block 32? - Ans-Service facility location information
A provider's office receives a subpoena requesting medical documentation from a patient's medical
record. After confirming the correct authorization, which of the following actions should the billing
and coding specialist take? - Ans-Send the medical information pertaining to the dates of service
requested
Which of the following is the deadline for Medicare claim submission? - Ans-12 months from the
date of service
Which of the following forms does a third-party payer require for physician services? - Ans-CMS-
1500
A billing and coding specialist submitted a claim to Medicare electronically. No errors were found by
,the billing software or clearinghouse. Which of the following describes this claim? - Ans-Clean claim
Which of the following qualifies as an exception to the HIPAA Privacy Rule? - Ans-Psychotherapy
notes
Which of the following would result in a claim being denied? - Ans-An italicized code used as the first
listed diagnosis
Which of the following standardized formats are used in the electronic filing of claims? - Ans-HIPAA
standard transactions
Which of the following describes a two-digit CPT code used to indicate that the provider supervised
an interpreted a radiology procedure? - Ans-Professional component
Which of the following formats are used to submit electronic claims to a third-party payer? - Ans-
837
Urine moved from the kidneys to the bladder through which of the following parts of the body? -
Ans-Ureters
As of April 1, 2014, what is the maximum number of diagnoses that can be reported on the CMS-
1500 claim form before a further claim is required? - Ans-12
Which of the following does a patient sign to allow payment of claims directly to the provider? - Ans-
Assignment of benefits
Which of the following is the primary function of the heart? - Ans-Pumping blood in the circulatory
system
Which of the following is true regarding Medicaid eligibility? - Ans-Patient eligibility is determined
monthly
The explanation of benefits states the amount billed was $80. The allowed amount is $60, and the
patient is required to pay a $20 copayment. Which of the following describes the insurance check
amount to be posted? - Ans-$40
, Which of the following provisions ensures that an insured's benefits from all insurance companies
do not exceed 100% of allowable medical expenses? - Ans-Coordination of benefits
3
