CBCS Practice Exam Predicted Questions 2022| 300
Questions| with 100% Correct Answers
The centers for medicare and medicaid service (CMS) is an administration within the ____ Correct
Answer: department of health and human services
A health care practioiner is also called a health care Correct Answer: provider
the process of assigning diagnoses, procedures, and services using numeric and alphanumeric characters
is called Correct Answer: coding
If a health insurance plan's prior approval requirement are not met by providers Correct Answer:
payment of the claim is denied
which coding system is used to report diagnoses and claims Correct Answer: ICD-10-CM
The CPT coding system is published by the Correct Answer: AMA
National codes are associated with blank and are used to report procedures, services, and supplies not
classified in CPT Correct Answer: HCPCS level II
Which report is sent to the patient by the payer to clarify the results of claims processing? Correct
Answer: a explanation of benefits
A remittance advice contains Correct Answer: payment information about a claim
Which type of insurance guarantees repayment for financial losses resulting from an employee's act or
failure to act Correct Answer: bonding
Physicians and other healthcare professionals purchase __________insurance to protect them from
liability relating to claims arising from patient treatment Correct Answer: medical malpractice
The administrative agency responsible for establishing rules for Medicare claims processing is called the
Correct Answer: Centers for Medicare and Medicaid Services (CMS)
Patients with health insurance may require blank for treatment by specialist and documentation of post
treatment reports Correct Answer: prior approval
The principles of right and good conduct are known as Correct Answer: ethics
Matching ICD-10-CM diagnosis codes to CPT and HCPCS level II procedure and service codes on a claim
submitted for a patient encounter ensures that services and procedures are reasonable and necessary
for the diagnosis or treatment of an illness or injury. This concept is called __________. Correct Answer:
medical necessity
,Which is submitted to the payer requesting reimbursement for physician and/or outpatient claims
Correct Answer: CMS-1500 claim form
Which coding system is used to report diagnoses and conditions on claims? Correct Answer: CPT
Which type of insurance covers employees and their dependents against injury and death that occurs
during the course of employment Correct Answer: worker's compensation
The word embezzle means to Correct Answer: steal
The Healthcare Common Procedure Coding System (HCPCS) consists of _______________codes Correct
Answer: CPT and national
ICD-10-PCS is an entirely new procedure classification system that was developed by CMS for use in
__________ settings only, replacing Volume 3 of ICD-9-CM. Correct Answer: inpatient hospital
The percentage of costs a patient shares with the health plan(eg., plan pays 80% costs and patient pays
20%) is called Correct Answer: coinsurance
The Clinical Laboratory Improvement Act (CLIA) established quality standards for all laboratory testing to
ensure the accuracy,reliability, and timeliness of patient test results Correct Answer: regardless of
where the test was performed
CMS developed the National Correct Coding Initiative (NCCI) to _______________. NCCI edits are
developed based on coding conventions defined in the CPT Correct Answer: eliminates improper coding
and promote national correct coding methodologies
The intent of HIPAA legislation is to Correct Answer: creates better access to health insurance, limit
fraud and abuse, and reduce administrative costs
The problem -oriented record (POR) includes the following four components: Correct Answer: database,
problem list, initial plan, progress notes
The electronic health record (EHR) allows patient information to be created at different locations
according to a unique patient identifier or identification number, which is called Correct Answer: record
linkage
The provider who uses the SOAP format documents the physical examination in the
________________portion of the clinic note Correct Answer: objective
The patient undergoes arthroscopic surgery at an ambulatory surgical center. The surgeon's fee is $890.
The patient's coinsurance is 20% of the $700 fee schedule, and the patient is not required to pay any
additional amount to the provider. The payer reimburses the surgeon 80% of the $700 fee schedule
Correct Answer: a Enter the amount the patient pays to provider $140
b Enter the amount the payer reimburses the provider $560
c Enter the amount the provider "writes off" the account $190
, Total practice management software (TPMS) is used to generate the EMR, automating which of the
following medical practice functions Correct Answer: patient registration and appointment
The Veterans Healthcare Expansion Act of 1973 authorized by Veterans Affairs established
_______________to provide healthcare benefits for dependents of veterans rated as 100% permanently
and totally disabled, who died as a result of service-connected conditions and veterans who died on
duty with less than 30 days of active service Correct Answer: CHAMPVA
HCPCS Level II codes (released in 1984) are developed and maintained by ________________and do not
carry the copyright of a private organization, which means they are in the public domain and many
publishers print annual coding manuals Correct Answer: CMS
A new fee schedule for Medicare services (Medicare physician fee schedule) was implemented as part of
OBRA in 1989 and 1990, replacing the regional "usual and reasonable" payment basis with a fixed fee
schedule Correct Answer: RBRVS (resource based value scale)
By whom is the employer identification number (EIN) assigned? Correct Answer: Internal Revenue
Service
The primary purpose of the record is to provide for ______________ which involves documenting
patient care services so that others who treat the patient have a source of information to assist with
additional care and treatment Correct Answer: continuity of care
The Patient Protection and Affordable Care Act (PPCA) amended the time period for filing Medicare fee-
for-service claims to __________________calendar years(s) after the date of service as the maximum
time period for submission of all Medicare FFS claims Correct Answer: one
Which party signs a contract with the health insurance company and thus, owns the health insurance
policy Correct Answer: policyholder
Which type of health insurance coverage is subsidized by employers and other organizations, with costs
that are typically less per person and provides broader coverage Correct Answer: group health
insurance
Which type of health insurance is purchased by families who do not have access to employer-subsidized
coverage Correct Answer: individual health insurance
The International Classification of Diseases, 10th revision, Clinical Modification, is published by the
World Health Organization (WHO) and used to classify ___________________data from death
certificates Correct Answer: mortality
Title XIX of the Social Security Act Amendment of 1965 is a cost-sharing program between the federal
and state governments to provide healthcare services to low-income Americans. Is a government plan
known as Correct Answer: Medicaid
Amendments to the Dependents' Medical Care Act of 1956 created the Civilian Health and Medical
Program-Uniformed Services (CHAMPUS), which was designed as a benefit for dependents of personnel
Questions| with 100% Correct Answers
The centers for medicare and medicaid service (CMS) is an administration within the ____ Correct
Answer: department of health and human services
A health care practioiner is also called a health care Correct Answer: provider
the process of assigning diagnoses, procedures, and services using numeric and alphanumeric characters
is called Correct Answer: coding
If a health insurance plan's prior approval requirement are not met by providers Correct Answer:
payment of the claim is denied
which coding system is used to report diagnoses and claims Correct Answer: ICD-10-CM
The CPT coding system is published by the Correct Answer: AMA
National codes are associated with blank and are used to report procedures, services, and supplies not
classified in CPT Correct Answer: HCPCS level II
Which report is sent to the patient by the payer to clarify the results of claims processing? Correct
Answer: a explanation of benefits
A remittance advice contains Correct Answer: payment information about a claim
Which type of insurance guarantees repayment for financial losses resulting from an employee's act or
failure to act Correct Answer: bonding
Physicians and other healthcare professionals purchase __________insurance to protect them from
liability relating to claims arising from patient treatment Correct Answer: medical malpractice
The administrative agency responsible for establishing rules for Medicare claims processing is called the
Correct Answer: Centers for Medicare and Medicaid Services (CMS)
Patients with health insurance may require blank for treatment by specialist and documentation of post
treatment reports Correct Answer: prior approval
The principles of right and good conduct are known as Correct Answer: ethics
Matching ICD-10-CM diagnosis codes to CPT and HCPCS level II procedure and service codes on a claim
submitted for a patient encounter ensures that services and procedures are reasonable and necessary
for the diagnosis or treatment of an illness or injury. This concept is called __________. Correct Answer:
medical necessity
,Which is submitted to the payer requesting reimbursement for physician and/or outpatient claims
Correct Answer: CMS-1500 claim form
Which coding system is used to report diagnoses and conditions on claims? Correct Answer: CPT
Which type of insurance covers employees and their dependents against injury and death that occurs
during the course of employment Correct Answer: worker's compensation
The word embezzle means to Correct Answer: steal
The Healthcare Common Procedure Coding System (HCPCS) consists of _______________codes Correct
Answer: CPT and national
ICD-10-PCS is an entirely new procedure classification system that was developed by CMS for use in
__________ settings only, replacing Volume 3 of ICD-9-CM. Correct Answer: inpatient hospital
The percentage of costs a patient shares with the health plan(eg., plan pays 80% costs and patient pays
20%) is called Correct Answer: coinsurance
The Clinical Laboratory Improvement Act (CLIA) established quality standards for all laboratory testing to
ensure the accuracy,reliability, and timeliness of patient test results Correct Answer: regardless of
where the test was performed
CMS developed the National Correct Coding Initiative (NCCI) to _______________. NCCI edits are
developed based on coding conventions defined in the CPT Correct Answer: eliminates improper coding
and promote national correct coding methodologies
The intent of HIPAA legislation is to Correct Answer: creates better access to health insurance, limit
fraud and abuse, and reduce administrative costs
The problem -oriented record (POR) includes the following four components: Correct Answer: database,
problem list, initial plan, progress notes
The electronic health record (EHR) allows patient information to be created at different locations
according to a unique patient identifier or identification number, which is called Correct Answer: record
linkage
The provider who uses the SOAP format documents the physical examination in the
________________portion of the clinic note Correct Answer: objective
The patient undergoes arthroscopic surgery at an ambulatory surgical center. The surgeon's fee is $890.
The patient's coinsurance is 20% of the $700 fee schedule, and the patient is not required to pay any
additional amount to the provider. The payer reimburses the surgeon 80% of the $700 fee schedule
Correct Answer: a Enter the amount the patient pays to provider $140
b Enter the amount the payer reimburses the provider $560
c Enter the amount the provider "writes off" the account $190
, Total practice management software (TPMS) is used to generate the EMR, automating which of the
following medical practice functions Correct Answer: patient registration and appointment
The Veterans Healthcare Expansion Act of 1973 authorized by Veterans Affairs established
_______________to provide healthcare benefits for dependents of veterans rated as 100% permanently
and totally disabled, who died as a result of service-connected conditions and veterans who died on
duty with less than 30 days of active service Correct Answer: CHAMPVA
HCPCS Level II codes (released in 1984) are developed and maintained by ________________and do not
carry the copyright of a private organization, which means they are in the public domain and many
publishers print annual coding manuals Correct Answer: CMS
A new fee schedule for Medicare services (Medicare physician fee schedule) was implemented as part of
OBRA in 1989 and 1990, replacing the regional "usual and reasonable" payment basis with a fixed fee
schedule Correct Answer: RBRVS (resource based value scale)
By whom is the employer identification number (EIN) assigned? Correct Answer: Internal Revenue
Service
The primary purpose of the record is to provide for ______________ which involves documenting
patient care services so that others who treat the patient have a source of information to assist with
additional care and treatment Correct Answer: continuity of care
The Patient Protection and Affordable Care Act (PPCA) amended the time period for filing Medicare fee-
for-service claims to __________________calendar years(s) after the date of service as the maximum
time period for submission of all Medicare FFS claims Correct Answer: one
Which party signs a contract with the health insurance company and thus, owns the health insurance
policy Correct Answer: policyholder
Which type of health insurance coverage is subsidized by employers and other organizations, with costs
that are typically less per person and provides broader coverage Correct Answer: group health
insurance
Which type of health insurance is purchased by families who do not have access to employer-subsidized
coverage Correct Answer: individual health insurance
The International Classification of Diseases, 10th revision, Clinical Modification, is published by the
World Health Organization (WHO) and used to classify ___________________data from death
certificates Correct Answer: mortality
Title XIX of the Social Security Act Amendment of 1965 is a cost-sharing program between the federal
and state governments to provide healthcare services to low-income Americans. Is a government plan
known as Correct Answer: Medicaid
Amendments to the Dependents' Medical Care Act of 1956 created the Civilian Health and Medical
Program-Uniformed Services (CHAMPUS), which was designed as a benefit for dependents of personnel
