CBCS CERTIFICATION EXAM QUESTIONS
AND VERIFIED ANSWERS 2026
▶ Based on CPT integumentary coding guidelines, Mohs mocrographic
surgery involves the provider filling which of the following roles?. Answer:
Both the surgeon and pathologist
▶ A patient has a resection of the intestines with anastomosis through the
abdominal walls. which of the following is a type of anastomosis?. Answer:
Colostomy
▶ Which of the following is the purpose of an internal review in a providers
office?. Answer: To verify that the medical records and the billing record
match
▶ Which of the following is a valid ICD-10-CM principle?. Answer: Code
signs and symptoms in the absence of a definitive diagnosis
▶ Which of the following editing systems should a billing and coding
specialist reference to determine if a supplies and materials code should be
assigned to report a surgical tray used during an ambulatory procedure?.
Answer: National Correct Coding Initiative (NCCI)
▶ When should a billing and coding specialist initiate the collection of the
information needed to process a patient's insurance claim form?. Answer:
When the patient contacts the providers office and schedules an
appointment
▶ A patient wants to see an endocrinologist for a consultation about their
diabetes. But they must see their primary care provider for a referral to an
in network specialist first which of the following types of insurance does the
patient have. Answer: Health maintenance organization (HMO)
▶ A billing including specialist is reviewing the procedure notes from a
provider who selected a code indicating an incisional biopsy when the
entirety of the patient's lesion was removed. The specialist should verify
, with the provider that which of the following types of procedures was
performed. Answer: excisional procedure
▶ A billing and coding specialist is reviewing a report from the
clearinghouse after submitting electronic claims and notices that one claim
was rejected due to missing demographic information. Which of the
following actions should the specialist take?. Answer: Resubmit an
updated claim.
▶ A billing and coding specialist is reviewing a claim for a patient who
presented to the provider's office for an upper respiratory infection. During
the encounter, the patient also received the influenza vaccine. Which
modifier should be attached to the (E/M) code?. Answer: -25
▶ A patient is upset about a bill they received because their 3rd party payer
denied the claim. which of the following actions should the billing and
coding specialist take?. Answer: Inform the patient of the reason for the
denial
▶ A billing and coding specialist is assisting a patient who has capitated
health maintenance organization (HMO) and presents to the office with a
sinus infection. The specialist should identify that which of the following
statements is true regarding a capitated HMO?. Answer: Payment for the
encounter is based on a flat rate?
▶ When a patient has condition that is both acute and chronic. How should
it be coded?. Answer: Code both the acute and chronic conditions,
sequencing the acute condition first.
▶ A billing and coding specialist is preparing an appeal letter in response to
a denial by a third-party payer for lack of medical necessity. which of the
following should the specialist include with the letter to indicate medical
necessity?. Answer: Medical record documentation
▶ HIPAA transaction standards apply to which of the following entities?.
Answer: Healthcare Clearinghouses
▶ Which of the following symbols indicates an add on code in the CPT
manual?. Answer: plus sign
AND VERIFIED ANSWERS 2026
▶ Based on CPT integumentary coding guidelines, Mohs mocrographic
surgery involves the provider filling which of the following roles?. Answer:
Both the surgeon and pathologist
▶ A patient has a resection of the intestines with anastomosis through the
abdominal walls. which of the following is a type of anastomosis?. Answer:
Colostomy
▶ Which of the following is the purpose of an internal review in a providers
office?. Answer: To verify that the medical records and the billing record
match
▶ Which of the following is a valid ICD-10-CM principle?. Answer: Code
signs and symptoms in the absence of a definitive diagnosis
▶ Which of the following editing systems should a billing and coding
specialist reference to determine if a supplies and materials code should be
assigned to report a surgical tray used during an ambulatory procedure?.
Answer: National Correct Coding Initiative (NCCI)
▶ When should a billing and coding specialist initiate the collection of the
information needed to process a patient's insurance claim form?. Answer:
When the patient contacts the providers office and schedules an
appointment
▶ A patient wants to see an endocrinologist for a consultation about their
diabetes. But they must see their primary care provider for a referral to an
in network specialist first which of the following types of insurance does the
patient have. Answer: Health maintenance organization (HMO)
▶ A billing including specialist is reviewing the procedure notes from a
provider who selected a code indicating an incisional biopsy when the
entirety of the patient's lesion was removed. The specialist should verify
, with the provider that which of the following types of procedures was
performed. Answer: excisional procedure
▶ A billing and coding specialist is reviewing a report from the
clearinghouse after submitting electronic claims and notices that one claim
was rejected due to missing demographic information. Which of the
following actions should the specialist take?. Answer: Resubmit an
updated claim.
▶ A billing and coding specialist is reviewing a claim for a patient who
presented to the provider's office for an upper respiratory infection. During
the encounter, the patient also received the influenza vaccine. Which
modifier should be attached to the (E/M) code?. Answer: -25
▶ A patient is upset about a bill they received because their 3rd party payer
denied the claim. which of the following actions should the billing and
coding specialist take?. Answer: Inform the patient of the reason for the
denial
▶ A billing and coding specialist is assisting a patient who has capitated
health maintenance organization (HMO) and presents to the office with a
sinus infection. The specialist should identify that which of the following
statements is true regarding a capitated HMO?. Answer: Payment for the
encounter is based on a flat rate?
▶ When a patient has condition that is both acute and chronic. How should
it be coded?. Answer: Code both the acute and chronic conditions,
sequencing the acute condition first.
▶ A billing and coding specialist is preparing an appeal letter in response to
a denial by a third-party payer for lack of medical necessity. which of the
following should the specialist include with the letter to indicate medical
necessity?. Answer: Medical record documentation
▶ HIPAA transaction standards apply to which of the following entities?.
Answer: Healthcare Clearinghouses
▶ Which of the following symbols indicates an add on code in the CPT
manual?. Answer: plus sign
