CBCS Practice Test
Which of the following sections of the medical record is used to determine the correct
evaluation and management code used for billing and coding? - ANSWER: history and
physical
A billing and coding specialist is reviewing a CMS-1500 claim form. The "assignment of
benefits" box has been checked "yes." The checked box indicates which of the
following? - ANSWER: The provider receives payment directly from the payer
Which of the following do physicians use to electronically submit a claim? - ANSWER:
Clearinghouse
Which of the following should the billing and coding specialist include in an authorization
to release information? - ANSWER: The entity to whom the information is to be released
Which of the following describes the content of a medical practice aging report? -
ANSWER: An overview of the practice's outstanding claims
HIPAA transaction standards apply to which of the following entities? - ANSWER:
Health care clearinghouses
When a physician documents a patient's response to symptoms and various body
systems, the results are documented as which of the following? - ANSWER: Review of
systems
Which part of Medicare covers prescriptions? - ANSWER: Part D
Which of the following indicates a claim should be submitted on paper instead of
electronically? - ANSWER: The claim requires an attachment
Medicare enforces mandatory submission of electronic claims for most providers. Which
of the following providers is allowed to submit paper claims to Medicare? - ANSWER: A
provider's office with fewer than 10 full-time employees
Which of the following is the correct term for an amount that has been determined to be
uncollectible? - ANSWER: Bad debt
Which of the following statements are correct regarding a deductible? - ANSWER: The
deductible is the patient's responsibility
Which of the following statements is true regarding the release of patient records? -
ANSWER: Patient access to psychotherapy notes may be restricted
,Why does correct claim processing rely on accurately completed encounter forms? -
ANSWER: They streamline patient billing by summarizing the services rendered for a
given date of service
When posting payment accurately. Which of the following items should the billing and
coding specialist include? - ANSWER: Patient's responsibility
A dependent child whose parents both have insurance coverage come to the clinic. The
billing and coding specialist uses the birthday rule determine which insurance policy is
primary. Which of the following describes the birthday rule? - ANSWER: The patient
whose birthday comes first in the calendar year
Which of the following actions should the billing and coding specialist take to effectively
manage accounts receivable? - ANSWER: Collect copayment from the patient at the
time of service
If a patient has osteomyelitis, he has problems with which of the following areas? -
ANSWER: bones, bone marrow
Which of the following are used by providers to remove errors from claims before they
are submitted to third-party payers? - ANSWER: Clearinghouse
A provider receives a reimbursement from a third-party payer accompanied by which of
the following documents? - ANSWER: explanation of benefits
Which of the following is the appropriate diagnosis for a patient who has an abnormal
accumulation of fluid in her lower leg that has resulted in swelling? - ANSWER: Edema
Which of the following blocks on the CMS-1500 claim form is used to bill ICD codes? -
ANSWER: Block 21
Patient charges that have not been paid to appear in which of the following? -
ANSWER: Accounts receivable
A physician is contracted with an insurance company to accept the allowed amount.
The insurance company allows $80 of a $120 billed amount, And $50 of the deductible
has not been met. How much should the physician write off the patient's record? -
ANSWER: $40
This is the difference between the amount billed and allowed amount. The physician
should write off $40.
A provider performs an examination of a patient sore throat during an office visit. Which
of the following describes the level of the examination? - ANSWER: Problem-focused
examination
, When building a secondary insurance company, which block should be billing and
coding specialist fill out on the CMS-1500 claim form? - ANSWER: 9a
Which of the following forms must be patient or representative sign to allow the release
of protected health information? - ANSWER: An Authorization
What is the maximum number of ICD codes that can be entered on a CMS-1500 claim
form as of February 2012? - ANSWER: 12
After a third-party payer validates a claim, which of the following takes place next? -
ANSWER: Claim adjudication
When a patient has a condition that is both acute and chronic, how should I be
reported? - ANSWER: Code both acute and chronic sequencing the acute first
Which of the following acts applies to the Administrative Simplification guidelines? -
ANSWER: Health Insurance Portability and Accountability Act (HIPAA)
After reading a providers notes about a new patient, a coding specialist decides to code
for a longer length of time than the actual office visit. Which of the following describes
the specialist's action? - ANSWER: Fraud
A biller will electronically submit a claim to the carrier via which of the following? -
ANSWER: Direct Data Entry
Which of the following is the purpose of running an aging report each month? -
ANSWER: It indicates which claims are outstanding
Which of the following is a type of claim that will be denied by the third-party payer? -
ANSWER: incomplete claim
Which of the following actions should the billing and coding specialist take to prevent
fraud and abuse in the medical office? - ANSWER: Internal monitoring and auditing
Which of the following is a verbal or written agreement that gives approval to release
protected health information (PHI)? - ANSWER: consent
Which of the following is a requirement of some Third-party payers before a procedure
is performed? - ANSWER: Preauthorization form
Which of the following is the function of the respiratory system? - ANSWER:
Oxygenating blood cells
The destruction of lesions using cryosurgery would use which of the following
treatments? - ANSWER: cold treatment
Which of the following sections of the medical record is used to determine the correct
evaluation and management code used for billing and coding? - ANSWER: history and
physical
A billing and coding specialist is reviewing a CMS-1500 claim form. The "assignment of
benefits" box has been checked "yes." The checked box indicates which of the
following? - ANSWER: The provider receives payment directly from the payer
Which of the following do physicians use to electronically submit a claim? - ANSWER:
Clearinghouse
Which of the following should the billing and coding specialist include in an authorization
to release information? - ANSWER: The entity to whom the information is to be released
Which of the following describes the content of a medical practice aging report? -
ANSWER: An overview of the practice's outstanding claims
HIPAA transaction standards apply to which of the following entities? - ANSWER:
Health care clearinghouses
When a physician documents a patient's response to symptoms and various body
systems, the results are documented as which of the following? - ANSWER: Review of
systems
Which part of Medicare covers prescriptions? - ANSWER: Part D
Which of the following indicates a claim should be submitted on paper instead of
electronically? - ANSWER: The claim requires an attachment
Medicare enforces mandatory submission of electronic claims for most providers. Which
of the following providers is allowed to submit paper claims to Medicare? - ANSWER: A
provider's office with fewer than 10 full-time employees
Which of the following is the correct term for an amount that has been determined to be
uncollectible? - ANSWER: Bad debt
Which of the following statements are correct regarding a deductible? - ANSWER: The
deductible is the patient's responsibility
Which of the following statements is true regarding the release of patient records? -
ANSWER: Patient access to psychotherapy notes may be restricted
,Why does correct claim processing rely on accurately completed encounter forms? -
ANSWER: They streamline patient billing by summarizing the services rendered for a
given date of service
When posting payment accurately. Which of the following items should the billing and
coding specialist include? - ANSWER: Patient's responsibility
A dependent child whose parents both have insurance coverage come to the clinic. The
billing and coding specialist uses the birthday rule determine which insurance policy is
primary. Which of the following describes the birthday rule? - ANSWER: The patient
whose birthday comes first in the calendar year
Which of the following actions should the billing and coding specialist take to effectively
manage accounts receivable? - ANSWER: Collect copayment from the patient at the
time of service
If a patient has osteomyelitis, he has problems with which of the following areas? -
ANSWER: bones, bone marrow
Which of the following are used by providers to remove errors from claims before they
are submitted to third-party payers? - ANSWER: Clearinghouse
A provider receives a reimbursement from a third-party payer accompanied by which of
the following documents? - ANSWER: explanation of benefits
Which of the following is the appropriate diagnosis for a patient who has an abnormal
accumulation of fluid in her lower leg that has resulted in swelling? - ANSWER: Edema
Which of the following blocks on the CMS-1500 claim form is used to bill ICD codes? -
ANSWER: Block 21
Patient charges that have not been paid to appear in which of the following? -
ANSWER: Accounts receivable
A physician is contracted with an insurance company to accept the allowed amount.
The insurance company allows $80 of a $120 billed amount, And $50 of the deductible
has not been met. How much should the physician write off the patient's record? -
ANSWER: $40
This is the difference between the amount billed and allowed amount. The physician
should write off $40.
A provider performs an examination of a patient sore throat during an office visit. Which
of the following describes the level of the examination? - ANSWER: Problem-focused
examination
, When building a secondary insurance company, which block should be billing and
coding specialist fill out on the CMS-1500 claim form? - ANSWER: 9a
Which of the following forms must be patient or representative sign to allow the release
of protected health information? - ANSWER: An Authorization
What is the maximum number of ICD codes that can be entered on a CMS-1500 claim
form as of February 2012? - ANSWER: 12
After a third-party payer validates a claim, which of the following takes place next? -
ANSWER: Claim adjudication
When a patient has a condition that is both acute and chronic, how should I be
reported? - ANSWER: Code both acute and chronic sequencing the acute first
Which of the following acts applies to the Administrative Simplification guidelines? -
ANSWER: Health Insurance Portability and Accountability Act (HIPAA)
After reading a providers notes about a new patient, a coding specialist decides to code
for a longer length of time than the actual office visit. Which of the following describes
the specialist's action? - ANSWER: Fraud
A biller will electronically submit a claim to the carrier via which of the following? -
ANSWER: Direct Data Entry
Which of the following is the purpose of running an aging report each month? -
ANSWER: It indicates which claims are outstanding
Which of the following is a type of claim that will be denied by the third-party payer? -
ANSWER: incomplete claim
Which of the following actions should the billing and coding specialist take to prevent
fraud and abuse in the medical office? - ANSWER: Internal monitoring and auditing
Which of the following is a verbal or written agreement that gives approval to release
protected health information (PHI)? - ANSWER: consent
Which of the following is a requirement of some Third-party payers before a procedure
is performed? - ANSWER: Preauthorization form
Which of the following is the function of the respiratory system? - ANSWER:
Oxygenating blood cells
The destruction of lesions using cryosurgery would use which of the following
treatments? - ANSWER: cold treatment
