NHA Billing and Coding practice test (CBCS)
The attending physician
A nurse is reviewing a patients lab results prior to discharge and discovers an elevated
glucose level. Which of the following health care providers should be altered before the
nurse can proceed with discharge planning?
The patients condition and the providers information
On the CMS-1500 Claims for, blocks 14 through 33 contain information about which of
the following?
Problem focused examination
A provider performs an examination of a patient's throat during an office visit. Which of
the following describes the level of the examination?
Reinstated or recycled code
The symbol "O" in the Current Procedural Terminology reference is used to indicate
which of the following?
Coinsurance
Which of the following is the portion of the account balance the patient must pay after
services are rendered and the annual deductible is met?
Place of service
The billing and coding specialist should divide the evaluation and management code by
which of the following?
Cardiovascular system
The standard medical abbreviation "ECG" refers to a test used to access which of the
following body systems?
add on codes
In the anesthesia section of the CPT manual, which of the following are considered
qualifying circumstances?
12
As of April 1st 2014, what is the maximum number of diagnosis that can be reported on
the CMS-1500 claim form before a further claim is required?
Nephrolithiasis
When submitting a clean claim with a diagnosis of kidney stones, which of the following
procedure names is correct?
Verifying that the medical records and the billing record match
Which of the following is one of the purposes of an internal auditing program in a
physician's office?
The DOB is entered incorrectly
Patient: Jane Austin; Social Security # 555-22-1111; Medicare ID: 555-33-2222A; DOB:
05/22/1945. Claim information entered: Austin, Jane; Social Security #.: 555-22-1111;
Medicare ID No.: 555-33-2222A; DOB: 052245. Which of the following is a reason this
claim was rejected?
Operative report
Which of the following options is considered proper supportive documentation for
reporting CPT and ICD codes for surgical procedures?
Verify the age of the account
Which of the following actions should be taken first when reviewing delinquent claims?
, Claim control number
Which of the following components of an explanation of benefits expedites the process
of a phone appeal?
Bloc 24D contains the diagnosis code
A claim can be denied or rejected for which of the following reasons?
Privacy officer
To be compliant with HIPAA, which of the following positions should be assigned in
each office?
encrypted
All e-mail correspondence to a third party payer containing patients' protected health
information (PHI) should be
patient ledger account
A billing and coding specialist should understand that the financial record source that is
generated by a provider's office is called a
Coding compliance plan
Which of the following includes procedures and best practices for correct coding?
Health care clearinghouses
HIPAA transaction standards apply to which of the following entities?
Appeal the decision with a provider's report
Which of the following actions should be taken if an insurance company denies a
service as not medically necessary?
Accommodate the request and send the records
A patient with a past due balance requests that his records be sent to another provider.
Which of the following actions should be taken?
$48
A participating BlueCross/ BlueShield (BC/BS) provider receives an explanation of
benefits for a patient account. The charged amount was $100. BC/BS allowed $40 to
the patients annual deductible. BC/BS paid the balance at 80%. How much should the
patient expect to pay?
Deductible
The physician bills $500 to a patient. After submitting the claim to the insurance
company, the claim is sent back with no payment. The patient still owes $500 for this
year.
International Classification of Disease (ICD)
Which of the following is used to code diseases, injuries, impairments, and other health
related problems?
Ureters
Urine moves from the kidneys to the bladder through which of the following parts of the
body?
Angioplasty
Threading a catheter with a balloon into a coronary artery and expanding it to repair
arteries describes which of the following procedures?
To ensure the patient understands his portion of the bill
A patient's portion of the bill should be discussed with the patient before a procedure is
performed for which of the following reasons?
Performing periodic audits
The attending physician
A nurse is reviewing a patients lab results prior to discharge and discovers an elevated
glucose level. Which of the following health care providers should be altered before the
nurse can proceed with discharge planning?
The patients condition and the providers information
On the CMS-1500 Claims for, blocks 14 through 33 contain information about which of
the following?
Problem focused examination
A provider performs an examination of a patient's throat during an office visit. Which of
the following describes the level of the examination?
Reinstated or recycled code
The symbol "O" in the Current Procedural Terminology reference is used to indicate
which of the following?
Coinsurance
Which of the following is the portion of the account balance the patient must pay after
services are rendered and the annual deductible is met?
Place of service
The billing and coding specialist should divide the evaluation and management code by
which of the following?
Cardiovascular system
The standard medical abbreviation "ECG" refers to a test used to access which of the
following body systems?
add on codes
In the anesthesia section of the CPT manual, which of the following are considered
qualifying circumstances?
12
As of April 1st 2014, what is the maximum number of diagnosis that can be reported on
the CMS-1500 claim form before a further claim is required?
Nephrolithiasis
When submitting a clean claim with a diagnosis of kidney stones, which of the following
procedure names is correct?
Verifying that the medical records and the billing record match
Which of the following is one of the purposes of an internal auditing program in a
physician's office?
The DOB is entered incorrectly
Patient: Jane Austin; Social Security # 555-22-1111; Medicare ID: 555-33-2222A; DOB:
05/22/1945. Claim information entered: Austin, Jane; Social Security #.: 555-22-1111;
Medicare ID No.: 555-33-2222A; DOB: 052245. Which of the following is a reason this
claim was rejected?
Operative report
Which of the following options is considered proper supportive documentation for
reporting CPT and ICD codes for surgical procedures?
Verify the age of the account
Which of the following actions should be taken first when reviewing delinquent claims?
, Claim control number
Which of the following components of an explanation of benefits expedites the process
of a phone appeal?
Bloc 24D contains the diagnosis code
A claim can be denied or rejected for which of the following reasons?
Privacy officer
To be compliant with HIPAA, which of the following positions should be assigned in
each office?
encrypted
All e-mail correspondence to a third party payer containing patients' protected health
information (PHI) should be
patient ledger account
A billing and coding specialist should understand that the financial record source that is
generated by a provider's office is called a
Coding compliance plan
Which of the following includes procedures and best practices for correct coding?
Health care clearinghouses
HIPAA transaction standards apply to which of the following entities?
Appeal the decision with a provider's report
Which of the following actions should be taken if an insurance company denies a
service as not medically necessary?
Accommodate the request and send the records
A patient with a past due balance requests that his records be sent to another provider.
Which of the following actions should be taken?
$48
A participating BlueCross/ BlueShield (BC/BS) provider receives an explanation of
benefits for a patient account. The charged amount was $100. BC/BS allowed $40 to
the patients annual deductible. BC/BS paid the balance at 80%. How much should the
patient expect to pay?
Deductible
The physician bills $500 to a patient. After submitting the claim to the insurance
company, the claim is sent back with no payment. The patient still owes $500 for this
year.
International Classification of Disease (ICD)
Which of the following is used to code diseases, injuries, impairments, and other health
related problems?
Ureters
Urine moves from the kidneys to the bladder through which of the following parts of the
body?
Angioplasty
Threading a catheter with a balloon into a coronary artery and expanding it to repair
arteries describes which of the following procedures?
To ensure the patient understands his portion of the bill
A patient's portion of the bill should be discussed with the patient before a procedure is
performed for which of the following reasons?
Performing periodic audits
