CBCS PRACTICE EXAM QUESTIONS AND
DETAILED SOLUTIONS 2026
▶ 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
▶ Which of the following information is correct code symbols in CPT
manual?. Answer: A product pending FDA approval is indicated by a
lightening bolt symbol.
▶ Unlisted Codes can be found in which of the following locations in the
CPT manual?. Answer: The guidelines prior to each section.
▶ A billing and coding specialist is reviewing a remittance advice and
encounter's a denial of payment for CPT code 44950 (appendectomy). The
specialist discovers the ICD-10-CM code assigned to the claim was J32.1
(chronic frontal sinusitis). which of the following is the reason for this claim
denial?. Answer: Incorrectly linked codes were reported on the claim
▶ A billing and coding specialist discovers a suspicious billing activity that
may be fraudulent in the workplace. which of the following actions should
the specialist take?. Answer: Call the U.S. Dept. of health and human
services (DHHS) anonymous hotline.
▶ Which of the following should a billing and coding specialist complete to
be reimbursed for a provider's outpatient services?. Answer: CMS-1500
claim form
, ▶ a specialist is determining the level of service for an office visit for a new
patient. which of the following codes represents detailed history and
detailed exam with moderate medical decision-making?. Answer: 99204
▶ A billing and coding specialist should identify that which of the following
is used to improve the efficiency and effectiveness of the heath care
system as mandated by HIPAA for providers?. Answer: CMS-1500 Claim
form
▶ A billing and coding specialist should add modifier -50 to a code when
reporting which of the following?. Answer: a bilateral procedure
▶ An explanation of benefits states the amount billed was $80. The allowed
amount is $60, and the patient is required to pay $20 copayment. Which of
the following describes the insurance check amount to be posted?.
Answer: $40
▶ A new patient presents for an urgent care encounter. Which of the
following code sets should be used to report the encounter?. Answer:
Office or other outpatient services
▶ A star symbol in the CPT coding manual is used to indicate which of the
following?. Answer: Telemedicine
▶ Outstanding patient balances will appear on which of the following?.
Answer: accounts receivable
▶ Which of the following statements is true regarding the release of patient
records?. Answer: Patient access to psychotherapy notes is restricted.
▶ A specialist is posting a medicare remittance advice and identifies an
overpayment of $15. Which of the following actions should the specialist
take?. Answer: Notify medicare of overpayment within 60 days
▶ 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
DETAILED SOLUTIONS 2026
▶ 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
▶ Which of the following information is correct code symbols in CPT
manual?. Answer: A product pending FDA approval is indicated by a
lightening bolt symbol.
▶ Unlisted Codes can be found in which of the following locations in the
CPT manual?. Answer: The guidelines prior to each section.
▶ A billing and coding specialist is reviewing a remittance advice and
encounter's a denial of payment for CPT code 44950 (appendectomy). The
specialist discovers the ICD-10-CM code assigned to the claim was J32.1
(chronic frontal sinusitis). which of the following is the reason for this claim
denial?. Answer: Incorrectly linked codes were reported on the claim
▶ A billing and coding specialist discovers a suspicious billing activity that
may be fraudulent in the workplace. which of the following actions should
the specialist take?. Answer: Call the U.S. Dept. of health and human
services (DHHS) anonymous hotline.
▶ Which of the following should a billing and coding specialist complete to
be reimbursed for a provider's outpatient services?. Answer: CMS-1500
claim form
, ▶ a specialist is determining the level of service for an office visit for a new
patient. which of the following codes represents detailed history and
detailed exam with moderate medical decision-making?. Answer: 99204
▶ A billing and coding specialist should identify that which of the following
is used to improve the efficiency and effectiveness of the heath care
system as mandated by HIPAA for providers?. Answer: CMS-1500 Claim
form
▶ A billing and coding specialist should add modifier -50 to a code when
reporting which of the following?. Answer: a bilateral procedure
▶ An explanation of benefits states the amount billed was $80. The allowed
amount is $60, and the patient is required to pay $20 copayment. Which of
the following describes the insurance check amount to be posted?.
Answer: $40
▶ A new patient presents for an urgent care encounter. Which of the
following code sets should be used to report the encounter?. Answer:
Office or other outpatient services
▶ A star symbol in the CPT coding manual is used to indicate which of the
following?. Answer: Telemedicine
▶ Outstanding patient balances will appear on which of the following?.
Answer: accounts receivable
▶ Which of the following statements is true regarding the release of patient
records?. Answer: Patient access to psychotherapy notes is restricted.
▶ A specialist is posting a medicare remittance advice and identifies an
overpayment of $15. Which of the following actions should the specialist
take?. Answer: Notify medicare of overpayment within 60 days
▶ 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
