CBCS ACTUAL EXAM QUESTIONS AND
COMPLETE STUDY GUIDE 2026
▶ Which of the following terms describes the removal of the eye, adnexa,
and bony structure?. Answer: Exenteration
▶ Used with wounds for exploring the injury site. Answer: Exploration
▶ A billing and coding specialist is preparing an accounts receivable aging
report. The specialist should expect the report to include which of the
following?. Answer: Outstanding balances organized by date.
▶ In an outpatient setting, which of the following forms is used as a
financial report of all services provided to patient's?. Answer: patient
account record
▶ A specialist is working on a claim in which reimbursement was reduced
due to services being bundled. Which of the following types of modifiers
should be assigned to indicate multiple procedures were performed in
prevent bundling?. Answer: Category 1 modifier
▶ Which of the following entities are required to follow HIPAA rules and
regulations?. Answer: Clearinghouses, health insurance companies, and
billing services.
▶ A providers office fee is $100 and the Medicare Part B allowed is $85.
Assuming the beneficiary has not met their deductible, the patient should
be billed for which of the following amounts?. Answer: $85
▶ A specialist is reviewing delinquent claims and discovers that a third-
party pater paid a claim but applied it to the incorrect provider. The third-
party will reimburse the payment once the improperly paid funds are
recouped. Which of the following terms is used to describe this claim?.
Answer: suspended
▶ A child is brought into a facility by the mother. The child is covered by
both parents insurance's. The child's father was born 10/1/1980. The
mother was born 10/2/1981. Which of the following statements is true
, regarding the primary policy holder for the child?. Answer: The father is the
primary policy holder because his Birthday falls first in the calendar year.
▶ A specialist is preparing a claim for a procedure with a prolonged
operative time that has modifier -22. Which of the following actions should
the specialist take?. Answer: Send a copy of the operative report with the
claim.
▶ A specialist is reviewing an encounter note that indicates biopsy was
performed. The specialist requires which of the following additional details
to fully code this procedure?. Answer: Benign vs. Malignant
▶ Which of the following information is required on a patient account
record?. Answer: Name and address of guarantor.
▶ A billing and coding specialist is preparing to appeal a partially paid claim
due to an incorrect code. Which of the following steps of the appeal
process includes the review of the claim adjustment reason code?.
Answer: identification
▶ Which of the following actions by a billing and coding specialist ensures
a patient's health information is protected?. Answer: Using data encryption
software on office workstations.
▶ A billing and coding specialist receives a denial for payment from
TRICARE for services provided in the emergency department while a
provider was on call. the provider is not a participating TRICARE provider.
Which of the following actions must the specialist take to process an appeal
for payment?. Answer: Contact the patient for assistance.
▶ A billing and coding specialist is reviewing a remittance advice from
medicare and notices that the amount paid for a procedure is less that the
contracted amount. Which of the following is a potential reason for the
reduced amount of payment?. Answer: The claim indicated an incorrect
place of service.
▶ A billing and coding specialist is collecting demographic information from
a patient. Which of the following pieces of information should the specialist
expect the Medicaid eligibility verification system (MEVS) to provide?.
Answer: Dates of coverage
COMPLETE STUDY GUIDE 2026
▶ Which of the following terms describes the removal of the eye, adnexa,
and bony structure?. Answer: Exenteration
▶ Used with wounds for exploring the injury site. Answer: Exploration
▶ A billing and coding specialist is preparing an accounts receivable aging
report. The specialist should expect the report to include which of the
following?. Answer: Outstanding balances organized by date.
▶ In an outpatient setting, which of the following forms is used as a
financial report of all services provided to patient's?. Answer: patient
account record
▶ A specialist is working on a claim in which reimbursement was reduced
due to services being bundled. Which of the following types of modifiers
should be assigned to indicate multiple procedures were performed in
prevent bundling?. Answer: Category 1 modifier
▶ Which of the following entities are required to follow HIPAA rules and
regulations?. Answer: Clearinghouses, health insurance companies, and
billing services.
▶ A providers office fee is $100 and the Medicare Part B allowed is $85.
Assuming the beneficiary has not met their deductible, the patient should
be billed for which of the following amounts?. Answer: $85
▶ A specialist is reviewing delinquent claims and discovers that a third-
party pater paid a claim but applied it to the incorrect provider. The third-
party will reimburse the payment once the improperly paid funds are
recouped. Which of the following terms is used to describe this claim?.
Answer: suspended
▶ A child is brought into a facility by the mother. The child is covered by
both parents insurance's. The child's father was born 10/1/1980. The
mother was born 10/2/1981. Which of the following statements is true
, regarding the primary policy holder for the child?. Answer: The father is the
primary policy holder because his Birthday falls first in the calendar year.
▶ A specialist is preparing a claim for a procedure with a prolonged
operative time that has modifier -22. Which of the following actions should
the specialist take?. Answer: Send a copy of the operative report with the
claim.
▶ A specialist is reviewing an encounter note that indicates biopsy was
performed. The specialist requires which of the following additional details
to fully code this procedure?. Answer: Benign vs. Malignant
▶ Which of the following information is required on a patient account
record?. Answer: Name and address of guarantor.
▶ A billing and coding specialist is preparing to appeal a partially paid claim
due to an incorrect code. Which of the following steps of the appeal
process includes the review of the claim adjustment reason code?.
Answer: identification
▶ Which of the following actions by a billing and coding specialist ensures
a patient's health information is protected?. Answer: Using data encryption
software on office workstations.
▶ A billing and coding specialist receives a denial for payment from
TRICARE for services provided in the emergency department while a
provider was on call. the provider is not a participating TRICARE provider.
Which of the following actions must the specialist take to process an appeal
for payment?. Answer: Contact the patient for assistance.
▶ A billing and coding specialist is reviewing a remittance advice from
medicare and notices that the amount paid for a procedure is less that the
contracted amount. Which of the following is a potential reason for the
reduced amount of payment?. Answer: The claim indicated an incorrect
place of service.
▶ A billing and coding specialist is collecting demographic information from
a patient. Which of the following pieces of information should the specialist
expect the Medicaid eligibility verification system (MEVS) to provide?.
Answer: Dates of coverage
