CBCS ACTUAL EXAM QUESTIONS AND
CORRECT ANSWERS [DETAILED ANSWERS]
2024 UPDATED VERSION CERTIFIED 100%
GRADED A+
What actions should be taken when a claim is billed for a level four office visit and paid at a
level three? - ANSWER>>Submit an appeal with documentation
The standard medical abbreviation "ECG" refers to a test used to assess which of the body
systems? - ANSWER>>cardiovascular system- test checks electricity of heart
According to HIPAA standards, what identifies the rendering provider on the CMS-1500 claim
form in Block 24J? - ANSWER>>NPI
On the CMS-1500 claim form, blocks 14 through 33 contain information about? -
ANSWER>>The patient's condition and the provider's information
Which block should the BCS complete on the CMS-1500 form for procedures, services, or
supplies? - ANSWER>>24D
Which term describes when a plan pays 70% of the allowed and the patient pays 30%? -
ANSWER>>Coinsurance is a percentage of the cost for covered services that is approved by the
insurance company
A provider charges $500 to a claim that had an allowable amount of $400. What should happen
to the non-allowed charge? - ANSWER>>Write Off or adjustment
Patient: Justin Austin; Social Security NO.: 555-22-1111; Medicare ID NO.: 555-33-2222A; DOB:
05/22/1945. Claim information entered: Austin, Jane; Social Security No.: 555-22-111; Medicare
ID No.: 555-33-2222A; DOB: 052245. What is a reason the claim was rejected? - ANSWER>>The
DOB is entered incorrectly - the format is two digits for the month and four digits for the year.
A patient's health plan is referred to as the "payer of last resort." The patient is covered by
which health plan? - ANSWER>>Medicaid
, 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 the year. This amount is
called what? - ANSWER>>Deductible
Ambulatory surgery centers, home health care, and hospice organizations use what form? -
ANSWER>>UB-04 Form
A physician ordered a comprehensive metabolic panel for a 70-year-old patient who has
Medicare as her primary insurance. Which form is required so the patient knows she may be
responsible for payment? - ANSWER>>Advanced Beneficiary Notice is a form that is required
for Medicare recipients
Which of the following should the BCS complete to be reimbursed for the provider's services? -
ANSWER>>CMS-1500 claim form
What is the maximum number of diagnoses that can be reported on the CMS-1500 claim form
before a further claim is required? - ANSWER>>12
Describe a delinquent claim? - ANSWER>>It is considered delinquent when it is overdue for
payment, 120 days or older
What are considered proper supportive documentation for reporting CPT and ICD codes for
surgical procedures? - ANSWER>>Operative reports are required to support surgical procedures
When submitting a clean claim with a diagnosis of kidney stones, which of the following
procedure names is correct? - ANSWER>>Nephrolithiasis The destruction of kidney stones
The BCS should first divide the e/m code by which of the following? - ANSWER>>Place of
service which narrows down the specific code as one of the three deciding factors
Appeal the decision with a provider's report - ANSWER>>Which of the following actions should
be taken if an insurance company denies a service as not medically necessary?
Which departments should a patient be seen for psoriasis? And what body system is involved? -
ANSWER>>Dermatology, related to the integumentary system which includes hair, skin, and
nails
CORRECT ANSWERS [DETAILED ANSWERS]
2024 UPDATED VERSION CERTIFIED 100%
GRADED A+
What actions should be taken when a claim is billed for a level four office visit and paid at a
level three? - ANSWER>>Submit an appeal with documentation
The standard medical abbreviation "ECG" refers to a test used to assess which of the body
systems? - ANSWER>>cardiovascular system- test checks electricity of heart
According to HIPAA standards, what identifies the rendering provider on the CMS-1500 claim
form in Block 24J? - ANSWER>>NPI
On the CMS-1500 claim form, blocks 14 through 33 contain information about? -
ANSWER>>The patient's condition and the provider's information
Which block should the BCS complete on the CMS-1500 form for procedures, services, or
supplies? - ANSWER>>24D
Which term describes when a plan pays 70% of the allowed and the patient pays 30%? -
ANSWER>>Coinsurance is a percentage of the cost for covered services that is approved by the
insurance company
A provider charges $500 to a claim that had an allowable amount of $400. What should happen
to the non-allowed charge? - ANSWER>>Write Off or adjustment
Patient: Justin Austin; Social Security NO.: 555-22-1111; Medicare ID NO.: 555-33-2222A; DOB:
05/22/1945. Claim information entered: Austin, Jane; Social Security No.: 555-22-111; Medicare
ID No.: 555-33-2222A; DOB: 052245. What is a reason the claim was rejected? - ANSWER>>The
DOB is entered incorrectly - the format is two digits for the month and four digits for the year.
A patient's health plan is referred to as the "payer of last resort." The patient is covered by
which health plan? - ANSWER>>Medicaid
, 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 the year. This amount is
called what? - ANSWER>>Deductible
Ambulatory surgery centers, home health care, and hospice organizations use what form? -
ANSWER>>UB-04 Form
A physician ordered a comprehensive metabolic panel for a 70-year-old patient who has
Medicare as her primary insurance. Which form is required so the patient knows she may be
responsible for payment? - ANSWER>>Advanced Beneficiary Notice is a form that is required
for Medicare recipients
Which of the following should the BCS complete to be reimbursed for the provider's services? -
ANSWER>>CMS-1500 claim form
What is the maximum number of diagnoses that can be reported on the CMS-1500 claim form
before a further claim is required? - ANSWER>>12
Describe a delinquent claim? - ANSWER>>It is considered delinquent when it is overdue for
payment, 120 days or older
What are considered proper supportive documentation for reporting CPT and ICD codes for
surgical procedures? - ANSWER>>Operative reports are required to support surgical procedures
When submitting a clean claim with a diagnosis of kidney stones, which of the following
procedure names is correct? - ANSWER>>Nephrolithiasis The destruction of kidney stones
The BCS should first divide the e/m code by which of the following? - ANSWER>>Place of
service which narrows down the specific code as one of the three deciding factors
Appeal the decision with a provider's report - ANSWER>>Which of the following actions should
be taken if an insurance company denies a service as not medically necessary?
Which departments should a patient be seen for psoriasis? And what body system is involved? -
ANSWER>>Dermatology, related to the integumentary system which includes hair, skin, and
nails
