NHA Billing and Coding practice test (CBCS) -
Questions With Complete Solutions
The attending physician Correct Ans - 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 Correct Ans -
On the CMS-1500 Claims for, blocks 14 through 33 contain information about
which of the following?
Problem focused examination Correct Ans - 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 Correct Ans - The symbol "O" in the
Current Procedural Terminology reference is used to indicate which of the
following?
Coinsurance Correct Ans - 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 Correct Ans - The billing and coding specialist should
divide the evaluation and management code by which of the following?
Cardiovascular system Correct Ans - The standard medical
abbreviation "ECG" refers to a test used to access which of the following
body systems?
add on codes Correct Ans - In the anesthesia section of the CPT
manual, which of the following are considered qualifying circumstances?
12 Correct Ans - 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 Correct Ans - 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 Correct
Ans - Which of the following is one of the purposes of an internal
auditing program in a physician's office?
The DOB is entered incorrectly Correct Ans - 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 Correct Ans - 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 Correct Ans - Which of the following
actions should be taken first when reviewing delinquent claims?
Claim control number Correct Ans - Which of the following
components of an explanation of benefits expedites the process of a phone
appeal?
Bloc 24D contains the diagnosis code Correct Ans - A claim can be
denied or rejected for which of the following reasons?
Privacy officer Correct Ans - To be compliant with HIPAA, which of the
following positions should be assigned in each office?
encrypted Correct Ans - All e-mail correspondence to a third party
payer containing patients' protected health information (PHI) should be
patient ledger account Correct Ans - 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 Correct Ans - Which of the following includes
procedures and best practices for correct coding?
Health care clearinghouses Correct Ans - HIPAA transaction
standards apply to which of the following entities?
Appeal the decision with a provider's report Correct Ans - 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 Correct Ans - 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 Correct Ans - 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 Correct Ans - 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) Correct Ans - Which of
the following is used to code diseases, injuries, impairments, and other
health related problems?
Ureters Correct Ans - Urine moves from the kidneys to the bladder
through which of the following parts of the body?
Angioplasty Correct Ans - 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 Correct Ans -
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 Correct Ans - Which of the following
actions by the billing and coding specialists prevents fraud?
Name and address of guarantor Correct Ans - Which of the following
information is required on a patient account record?
Invalid Correct Ans - A claim is submitted with a transposed
insurance member ID number and returned to the provider. Which of the
following describes the status that should be assigned to the claim by the
carrier?
CMS-1500 claim form Correct Ans - Which of the following should the
billing and coding specialist complete to be reimbursed for the provider's
services?
The electronic transmission and code set standards require every provider to
use the healthcare transactions, code sets, and identifiers. Correct Ans
Questions With Complete Solutions
The attending physician Correct Ans - 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 Correct Ans -
On the CMS-1500 Claims for, blocks 14 through 33 contain information about
which of the following?
Problem focused examination Correct Ans - 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 Correct Ans - The symbol "O" in the
Current Procedural Terminology reference is used to indicate which of the
following?
Coinsurance Correct Ans - 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 Correct Ans - The billing and coding specialist should
divide the evaluation and management code by which of the following?
Cardiovascular system Correct Ans - The standard medical
abbreviation "ECG" refers to a test used to access which of the following
body systems?
add on codes Correct Ans - In the anesthesia section of the CPT
manual, which of the following are considered qualifying circumstances?
12 Correct Ans - 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 Correct Ans - 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 Correct
Ans - Which of the following is one of the purposes of an internal
auditing program in a physician's office?
The DOB is entered incorrectly Correct Ans - 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 Correct Ans - 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 Correct Ans - Which of the following
actions should be taken first when reviewing delinquent claims?
Claim control number Correct Ans - Which of the following
components of an explanation of benefits expedites the process of a phone
appeal?
Bloc 24D contains the diagnosis code Correct Ans - A claim can be
denied or rejected for which of the following reasons?
Privacy officer Correct Ans - To be compliant with HIPAA, which of the
following positions should be assigned in each office?
encrypted Correct Ans - All e-mail correspondence to a third party
payer containing patients' protected health information (PHI) should be
patient ledger account Correct Ans - 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 Correct Ans - Which of the following includes
procedures and best practices for correct coding?
Health care clearinghouses Correct Ans - HIPAA transaction
standards apply to which of the following entities?
Appeal the decision with a provider's report Correct Ans - 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 Correct Ans - 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 Correct Ans - 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 Correct Ans - 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) Correct Ans - Which of
the following is used to code diseases, injuries, impairments, and other
health related problems?
Ureters Correct Ans - Urine moves from the kidneys to the bladder
through which of the following parts of the body?
Angioplasty Correct Ans - 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 Correct Ans -
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 Correct Ans - Which of the following
actions by the billing and coding specialists prevents fraud?
Name and address of guarantor Correct Ans - Which of the following
information is required on a patient account record?
Invalid Correct Ans - A claim is submitted with a transposed
insurance member ID number and returned to the provider. Which of the
following describes the status that should be assigned to the claim by the
carrier?
CMS-1500 claim form Correct Ans - Which of the following should the
billing and coding specialist complete to be reimbursed for the provider's
services?
The electronic transmission and code set standards require every provider to
use the healthcare transactions, code sets, and identifiers. Correct Ans
