NHA CBCS Final Exam Practice Test Questions
with 100% Correct Answers | Verified | Latest
Update
which of the following is a key protection standard of the HIPAA privacy rule that requires entities and
business associates to limit the use or release of protected health information phi)?
Incidental use
Authorization
Minimum necessary
Disclosure.
minimum necessary
A billing and coding specialist is preparing a claim that includes code A9698. Which of the following
actions should the specialist take to ensure the claim will be paid the first time it is submitted?
• Add supplemental documentation with the claim.
• Append the appropriate physical status modifier to the code.
• Submit all claims for A9698 once a month as required.
• Remove the code A9698 and submit the claim.
append the appropriate physical status modifier to the code
Which of the following describes the status of a claim that is in process and does not include required
preauthorization for a service?
• Delinquent
• Denied
• Suspended
• Adjudicated
suspended
A third-party payer requests a patients information related to a claim. A billing and coding specialist
should ensure that which of the following is included in the patients file before providing the
information?
• Consent form
• Preauthorization form
• Signed release of information form
• Signed subpoena
signed release of information form
,A lightning bolt symbol that precedes a code indicates which of the following?
• The code is for a new procedure or service.
The code description has been revised.
The code indicates a service is pending FDA approval.
The code is exempt from modifier -51.
code indicates a service is pending FDA approval
A billing and coding specialist is using an accounts receivable aging report to determine which
accounts should be sent to collection. According to best practice, which of the following accounts
should the specialist send to collections?
An account that has a balance of $600 and is 135 days old
• An account that has a balance of $1,500 and is 60 days old
• An account that has a balance of $60 and is 45 days old
• An account that has a balance of $500 and is 110 days old
An account that has a balance of $600 and 135 days old.
Which of the following CPT codes should a billing and coding specialist use to indicate a total prostate
specific antigen (PSA) test?
•84154.
84152
84153
86304
84153
Which of the following is the purpose of a claims clearinghouse?
• To determine the reimbursement amount
• To identify errors that will prevent a claim from being paid
• To determine a patient's deductible amount
• To identify fraudulent practices
To identify errors that will prevent a claim from being paid
Which of the following describes a claim that is 120 days old?
Clean
• Delinquent
• Open
Closed
, delinquent
Which of the following plans requires providers to adhere to managed care provisions?
Office of Inspector General (OIG)
Compliance officer
• Department of Health and Human Services (HHS)
• Centers for Medicare and Medicaid Services (CMS) |
health maintenance organization (HMO) plan
According to the ICD-10-CM coding guidelines, the fourth character of an ICD-10-CM diagnosis code
indicates which of the following?
• Body system
• Extension
• Anatomic site
• Category.
anatomic site
Which of the following codes are used to code diseases, injuries, impairments, and other health-
related problems?
• Indemnity plan
Self-insured plan
Fee-for-service plan
Health maintenance organization (HMO) plan
ICD-10-CM codes
An internal retrospective billing account audit prevents fraud and abuse by reviewing and comparing
completed claim forms with which of the following?
• Documentation from patient encounters
• A subpoena
• Documentation of compliance plans
• An appeal letter I
Documentation of compliance plans
which of the following types of insurance do health care professionals purchase to protect themselves
from liability relating to claims arising from patient treatments?
Bonding
• Medical malpractice
• Workers' compensation
• Property
Property
medical malpractice
with 100% Correct Answers | Verified | Latest
Update
which of the following is a key protection standard of the HIPAA privacy rule that requires entities and
business associates to limit the use or release of protected health information phi)?
Incidental use
Authorization
Minimum necessary
Disclosure.
minimum necessary
A billing and coding specialist is preparing a claim that includes code A9698. Which of the following
actions should the specialist take to ensure the claim will be paid the first time it is submitted?
• Add supplemental documentation with the claim.
• Append the appropriate physical status modifier to the code.
• Submit all claims for A9698 once a month as required.
• Remove the code A9698 and submit the claim.
append the appropriate physical status modifier to the code
Which of the following describes the status of a claim that is in process and does not include required
preauthorization for a service?
• Delinquent
• Denied
• Suspended
• Adjudicated
suspended
A third-party payer requests a patients information related to a claim. A billing and coding specialist
should ensure that which of the following is included in the patients file before providing the
information?
• Consent form
• Preauthorization form
• Signed release of information form
• Signed subpoena
signed release of information form
,A lightning bolt symbol that precedes a code indicates which of the following?
• The code is for a new procedure or service.
The code description has been revised.
The code indicates a service is pending FDA approval.
The code is exempt from modifier -51.
code indicates a service is pending FDA approval
A billing and coding specialist is using an accounts receivable aging report to determine which
accounts should be sent to collection. According to best practice, which of the following accounts
should the specialist send to collections?
An account that has a balance of $600 and is 135 days old
• An account that has a balance of $1,500 and is 60 days old
• An account that has a balance of $60 and is 45 days old
• An account that has a balance of $500 and is 110 days old
An account that has a balance of $600 and 135 days old.
Which of the following CPT codes should a billing and coding specialist use to indicate a total prostate
specific antigen (PSA) test?
•84154.
84152
84153
86304
84153
Which of the following is the purpose of a claims clearinghouse?
• To determine the reimbursement amount
• To identify errors that will prevent a claim from being paid
• To determine a patient's deductible amount
• To identify fraudulent practices
To identify errors that will prevent a claim from being paid
Which of the following describes a claim that is 120 days old?
Clean
• Delinquent
• Open
Closed
, delinquent
Which of the following plans requires providers to adhere to managed care provisions?
Office of Inspector General (OIG)
Compliance officer
• Department of Health and Human Services (HHS)
• Centers for Medicare and Medicaid Services (CMS) |
health maintenance organization (HMO) plan
According to the ICD-10-CM coding guidelines, the fourth character of an ICD-10-CM diagnosis code
indicates which of the following?
• Body system
• Extension
• Anatomic site
• Category.
anatomic site
Which of the following codes are used to code diseases, injuries, impairments, and other health-
related problems?
• Indemnity plan
Self-insured plan
Fee-for-service plan
Health maintenance organization (HMO) plan
ICD-10-CM codes
An internal retrospective billing account audit prevents fraud and abuse by reviewing and comparing
completed claim forms with which of the following?
• Documentation from patient encounters
• A subpoena
• Documentation of compliance plans
• An appeal letter I
Documentation of compliance plans
which of the following types of insurance do health care professionals purchase to protect themselves
from liability relating to claims arising from patient treatments?
Bonding
• Medical malpractice
• Workers' compensation
• Property
Property
medical malpractice
