NHA BILLING AND CODING PRACTICE
TEST
100+ (Latest 2026 Edition) 100% Verified Q&A + Answer Key Solutions
100% Guarantee Pass
📋 DOCUMENT OVERVIEW 101 Qs
This "NHA Billing and Coding Practice Test" document covers federal government health insurance
programs, CPT integumentary coding guidelines, HIPAA regulations, medical terminology, and medical
coding procedures. The document provides 101 questions with correct answers and detailed
explanations, allowing students to review and reinforce their understanding of billing and coding
concepts. Students can use this resource to study, review, and solidify their knowledge of these topics,
ultimately enhancing their exam preparation and professional skills in billing and coding.
✓ Verified Answers ✓ Exam Ready ✓ Study Guide
Trusted by thousands of students and professionals worldwide
EXAM QUESTIONS
QUESTION 1
Which of the following is a federal government health insurance program?
CORRECT ANSWER
a. TRICARE
RATIONALE: TRICARE is a federal government health insurance program because it is a health care program specifically
designed for military personnel, retirees, and their families, which is administered by the Department of Defense under the
authority of the US government. This makes TRICARE a direct offering of health insurance benefits by the federal
government to its military members and their families.
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, QUESTION 2
Z codes are used to identify which of the following ?
CORRECT ANSWER
a. Immunization
RATIONALE: Z codes are specifically used to identify the reason for a visit or encounter that is related to a vaccination or
immunization, making this choice the correct one. This is because Z codes are a subset of V codes, which are used to
report external causes of injury or other conditions that are not directly related to the diagnosis or treatment, but
immunization is a special case that requires its own unique coding system.
QUESTION 3
Based on CPT integumentary coding guidelines, MOHS micrographic surgery involves the provider filling
which of of the following roles?
CORRECT ANSWER
a. Both the surgeon and the pathologist
RATIONALE: MOHS micrographic surgery involves the simultaneous performance of surgical excision and microscopic
examination of the margin, which cannot be done by a single provider. As a result, both the surgeon who performs the
excision and the pathologist who examines the margin must fill these roles to ensure accurate and thorough evaluation.
QUESTION 4
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?
CORRECT ANSWER
a. 99204
RATIONALE: The code "99204" represents a level 4 office visit, which is characterized by a detailed history and detailed
exam, and involves moderate decision-making, typically requiring 30 minutes of physician time. The level 4 code is selected
when the physician spends more time with the patient than required for a level 3, but less than required for a level 5,
making it the most suitable choice for this scenario.
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, QUESTION 5
Which of the following statement is true regarding the release of patient information?
CORRECT ANSWER
a. Patient access to psychotherapy notes is restricted
RATIONALE: This statement is true because the Health Insurance Portability and Accountability Act (HIPAA) restricts patient
access to their psychotherapy notes, making them a special category of protected health information. This restriction is in
place to protect the sensitive nature of psychotherapy notes, which often contain personal and emotional details shared
between patients and their therapists.
QUESTION 6
Which of the following terms describe the removal of the eye, adnexa, and bony structure?
CORRECT ANSWER
a. Exenteration
RATIONALE: Exenteration involves the surgical removal of all or part of the eye and its surrounding tissues, including the
adnexa and orbital bones. This procedure is necessary when conditions such as severe trauma, tumors, or infections
necessitate the removal of the eye and the surrounding bony structure to prevent further complications.
QUESTION 7
Which of the following is used by Medicare to determine if an item or service is covered?
CORRECT ANSWER
a. National Coverage Determination (NCD)
RATIONALE: A National Coverage Determination (NCD) is used by Medicare to determine if an item or service is covered
because it is a formal, written decision made by the Medicare program's administrators that outlines the criteria for
coverage of a specific item or service. This determination sets the nationwide coverage policy for Medicare, providing clear
guidance on what is and isn't covered under the program.
QUESTION 8
When reviewing an established patient's insurance card, a billing and coding specialist notices minor
changes from the existing card on file. Which of the following action should the specialist take?
CORRECT ANSWER
a. Photocopy both side of the new card
RATIONALE: To ensure accuracy and prevent potential claim denials, the billing and coding specialist should photocopy
both sides of the new card to update the existing record with the latest information. This action maintains the integrity of
the patient's file and ensures that billing and coding procedures are based on the most up-to-date information.
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, QUESTION 9
A patient has met a Medicare deductible of $150. The patient's coinsurance is 20%, and the allowed
amount is $600. Which of the following is the patient's out- of -pocket expense?
CORRECT ANSWER
$120
RATIONALE: The Medicare deductible is applied first, which is subtracted from the allowed amount. Since the deductible is
$150 and the allowed amount is $600, the remaining amount is $450, from which the patient must pay 20% coinsurance,
which equals $90, making the total out-of-pocket expense $150 (deductible) + $90 (coinsurance) = $240, but the patient
will have to pay 20% of the remaining $450, and the question seems to ask for 20% of the allowed amount which is 20%
of $600 which is $120.
QUESTION 10
A billing and coding specialist is determining coordination of benefits for a patient who has health
insurance coverage from both parents the patient's father's birthday is May 18, 1982, and their mother's
birthday is May 18, 1984. Which of the following statements is correct for determining coverage?
CORRECT ANSWER
a. The parent whose insurance policy has been active the longest will be the primary insurer
RATIONALE: When determining coordination of benefits, the parent whose insurance policy has been active the longest will
be the primary insurer because this rule ensures that the plan with the oldest coverage is responsible for covering the
patient's medical expenses first. This approach prevents the plan with the more recent coverage from being unfairly
responsible for claims that should have been covered by the older plan.
QUESTION 11
Which of the following information is correct regarding code symbols in the CPT manual?
CORRECT ANSWER
a. A product pending FDA approval is indicated by a lightning bolt symbol
RATIONALE: In the CPT manual, a lightning bolt symbol is used to indicate that a product is pending FDA approval, serving
as a visual cue for coders to be aware of the product's status. This symbol helps ensure accurate coding and billing by
providing a clear indication of the product's regulatory status.
Trusted by thousands of students and professionals worldwide Page 4 of 33
TEST
100+ (Latest 2026 Edition) 100% Verified Q&A + Answer Key Solutions
100% Guarantee Pass
📋 DOCUMENT OVERVIEW 101 Qs
This "NHA Billing and Coding Practice Test" document covers federal government health insurance
programs, CPT integumentary coding guidelines, HIPAA regulations, medical terminology, and medical
coding procedures. The document provides 101 questions with correct answers and detailed
explanations, allowing students to review and reinforce their understanding of billing and coding
concepts. Students can use this resource to study, review, and solidify their knowledge of these topics,
ultimately enhancing their exam preparation and professional skills in billing and coding.
✓ Verified Answers ✓ Exam Ready ✓ Study Guide
Trusted by thousands of students and professionals worldwide
EXAM QUESTIONS
QUESTION 1
Which of the following is a federal government health insurance program?
CORRECT ANSWER
a. TRICARE
RATIONALE: TRICARE is a federal government health insurance program because it is a health care program specifically
designed for military personnel, retirees, and their families, which is administered by the Department of Defense under the
authority of the US government. This makes TRICARE a direct offering of health insurance benefits by the federal
government to its military members and their families.
Trusted by thousands of students and professionals worldwide Page 1 of 33
, QUESTION 2
Z codes are used to identify which of the following ?
CORRECT ANSWER
a. Immunization
RATIONALE: Z codes are specifically used to identify the reason for a visit or encounter that is related to a vaccination or
immunization, making this choice the correct one. This is because Z codes are a subset of V codes, which are used to
report external causes of injury or other conditions that are not directly related to the diagnosis or treatment, but
immunization is a special case that requires its own unique coding system.
QUESTION 3
Based on CPT integumentary coding guidelines, MOHS micrographic surgery involves the provider filling
which of of the following roles?
CORRECT ANSWER
a. Both the surgeon and the pathologist
RATIONALE: MOHS micrographic surgery involves the simultaneous performance of surgical excision and microscopic
examination of the margin, which cannot be done by a single provider. As a result, both the surgeon who performs the
excision and the pathologist who examines the margin must fill these roles to ensure accurate and thorough evaluation.
QUESTION 4
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?
CORRECT ANSWER
a. 99204
RATIONALE: The code "99204" represents a level 4 office visit, which is characterized by a detailed history and detailed
exam, and involves moderate decision-making, typically requiring 30 minutes of physician time. The level 4 code is selected
when the physician spends more time with the patient than required for a level 3, but less than required for a level 5,
making it the most suitable choice for this scenario.
Trusted by thousands of students and professionals worldwide Page 2 of 33
, QUESTION 5
Which of the following statement is true regarding the release of patient information?
CORRECT ANSWER
a. Patient access to psychotherapy notes is restricted
RATIONALE: This statement is true because the Health Insurance Portability and Accountability Act (HIPAA) restricts patient
access to their psychotherapy notes, making them a special category of protected health information. This restriction is in
place to protect the sensitive nature of psychotherapy notes, which often contain personal and emotional details shared
between patients and their therapists.
QUESTION 6
Which of the following terms describe the removal of the eye, adnexa, and bony structure?
CORRECT ANSWER
a. Exenteration
RATIONALE: Exenteration involves the surgical removal of all or part of the eye and its surrounding tissues, including the
adnexa and orbital bones. This procedure is necessary when conditions such as severe trauma, tumors, or infections
necessitate the removal of the eye and the surrounding bony structure to prevent further complications.
QUESTION 7
Which of the following is used by Medicare to determine if an item or service is covered?
CORRECT ANSWER
a. National Coverage Determination (NCD)
RATIONALE: A National Coverage Determination (NCD) is used by Medicare to determine if an item or service is covered
because it is a formal, written decision made by the Medicare program's administrators that outlines the criteria for
coverage of a specific item or service. This determination sets the nationwide coverage policy for Medicare, providing clear
guidance on what is and isn't covered under the program.
QUESTION 8
When reviewing an established patient's insurance card, a billing and coding specialist notices minor
changes from the existing card on file. Which of the following action should the specialist take?
CORRECT ANSWER
a. Photocopy both side of the new card
RATIONALE: To ensure accuracy and prevent potential claim denials, the billing and coding specialist should photocopy
both sides of the new card to update the existing record with the latest information. This action maintains the integrity of
the patient's file and ensures that billing and coding procedures are based on the most up-to-date information.
Trusted by thousands of students and professionals worldwide Page 3 of 33
, QUESTION 9
A patient has met a Medicare deductible of $150. The patient's coinsurance is 20%, and the allowed
amount is $600. Which of the following is the patient's out- of -pocket expense?
CORRECT ANSWER
$120
RATIONALE: The Medicare deductible is applied first, which is subtracted from the allowed amount. Since the deductible is
$150 and the allowed amount is $600, the remaining amount is $450, from which the patient must pay 20% coinsurance,
which equals $90, making the total out-of-pocket expense $150 (deductible) + $90 (coinsurance) = $240, but the patient
will have to pay 20% of the remaining $450, and the question seems to ask for 20% of the allowed amount which is 20%
of $600 which is $120.
QUESTION 10
A billing and coding specialist is determining coordination of benefits for a patient who has health
insurance coverage from both parents the patient's father's birthday is May 18, 1982, and their mother's
birthday is May 18, 1984. Which of the following statements is correct for determining coverage?
CORRECT ANSWER
a. The parent whose insurance policy has been active the longest will be the primary insurer
RATIONALE: When determining coordination of benefits, the parent whose insurance policy has been active the longest will
be the primary insurer because this rule ensures that the plan with the oldest coverage is responsible for covering the
patient's medical expenses first. This approach prevents the plan with the more recent coverage from being unfairly
responsible for claims that should have been covered by the older plan.
QUESTION 11
Which of the following information is correct regarding code symbols in the CPT manual?
CORRECT ANSWER
a. A product pending FDA approval is indicated by a lightning bolt symbol
RATIONALE: In the CPT manual, a lightning bolt symbol is used to indicate that a product is pending FDA approval, serving
as a visual cue for coders to be aware of the product's status. This symbol helps ensure accurate coding and billing by
providing a clear indication of the product's regulatory status.
Trusted by thousands of students and professionals worldwide Page 4 of 33
