CBCS LATEST EXAM PREP QUESTIONS AND
ANSWERS PDF 2026
▶ 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
▶ A billing and coding specialist observes a colleague perform an unethical
act. which of the following actions should the specialist take?. Answer:
Report the incident to a supervisor.
▶ When a patient signs an Acknowledgement of Notice of Privacy Practice,
it indicates which of the following?. Answer: The patient accepts the
policies and procedures regarding how protected health information (PHI)
is handled.
, ▶ A specialist is processing a claim for a patient who broke their arm while
repairing cars at a workplace. There is no nerve damage. the arm is placed
in a cast for 6 weeks, and the patient is cleared to return to work in 6
weeks. Which type of workers' compensation applies to this patient?.
Answer: Temporary Disability
▶ Medigap coverage is offered to Medicare beneficiaries by. Answer:
Private 3rd party payers
▶ Which of the following qualifies a patient for eligibility under medicare as
the primary 3rd party payer?. Answer: Under 65 with a disability.
▶ An employer's workers' compensation payer requiresbloodwork for an
employee who experienced a work-related injury. Which of the following
modifiers shoulda billing and coding specialist use?. Answer: -32
▶ 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?. Answer: $120
▶ A specialist is reviewign a providers documentation for a patient who
underwent repair of multiple wounds to the face and trunk. The provider
coded repair of all wounds individually. The specialist should recognize that
the provider should have applied which of the following concepts to the
documentation of the repair for this patients wounds?. Answer: Wounds
should be grouped by anatomic site and coded in order of complexity.
▶ Which of the following CPT codes should a billing and coding specialist
use to bill for a 5-year-old child who had an initial repair of a 2.5 cm
abdominal hernia?. Answer: 49591
▶ a billing and coding specialist is reviewing a claim for an established
patient who arrived at the office with an upper respiratory infection. which of
the following codes should the specialist use for this encounter?. Answer:
99213
▶ a specialist discovers that one private payer has not reimbursed the
provider for any claims submitted in the past year. clean claims have been
submitted to the payer and have been acknowledged. which of the
following entities should the specialist contact to report the payer's failure to
submit timely reimbursement?. Answer: state insurance commissioners
office
ANSWERS PDF 2026
▶ 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
▶ A billing and coding specialist observes a colleague perform an unethical
act. which of the following actions should the specialist take?. Answer:
Report the incident to a supervisor.
▶ When a patient signs an Acknowledgement of Notice of Privacy Practice,
it indicates which of the following?. Answer: The patient accepts the
policies and procedures regarding how protected health information (PHI)
is handled.
, ▶ A specialist is processing a claim for a patient who broke their arm while
repairing cars at a workplace. There is no nerve damage. the arm is placed
in a cast for 6 weeks, and the patient is cleared to return to work in 6
weeks. Which type of workers' compensation applies to this patient?.
Answer: Temporary Disability
▶ Medigap coverage is offered to Medicare beneficiaries by. Answer:
Private 3rd party payers
▶ Which of the following qualifies a patient for eligibility under medicare as
the primary 3rd party payer?. Answer: Under 65 with a disability.
▶ An employer's workers' compensation payer requiresbloodwork for an
employee who experienced a work-related injury. Which of the following
modifiers shoulda billing and coding specialist use?. Answer: -32
▶ 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?. Answer: $120
▶ A specialist is reviewign a providers documentation for a patient who
underwent repair of multiple wounds to the face and trunk. The provider
coded repair of all wounds individually. The specialist should recognize that
the provider should have applied which of the following concepts to the
documentation of the repair for this patients wounds?. Answer: Wounds
should be grouped by anatomic site and coded in order of complexity.
▶ Which of the following CPT codes should a billing and coding specialist
use to bill for a 5-year-old child who had an initial repair of a 2.5 cm
abdominal hernia?. Answer: 49591
▶ a billing and coding specialist is reviewing a claim for an established
patient who arrived at the office with an upper respiratory infection. which of
the following codes should the specialist use for this encounter?. Answer:
99213
▶ a specialist discovers that one private payer has not reimbursed the
provider for any claims submitted in the past year. clean claims have been
submitted to the payer and have been acknowledged. which of the
following entities should the specialist contact to report the payer's failure to
submit timely reimbursement?. Answer: state insurance commissioners
office
