NHA MEDICAL BILLING AND
CODING EXAM 2025 QUESTIONS
AND 100% CORRECT ANSWERS
Billing and coding specialist should first divide the E/M code by
ANS: Place of Service
Complaint with HIPPA the following position should be assigned in each office
ANS: Privacy Officer
Coding on the UB-04 Form, must sequence the diagnosis code. Which is the first listed
diagnosis?
ANS: Principal Diagnosis
Obstruction of the urethra is?
ANS: Urethratresia
Ambulatory surgery centers, home health center, and hospice use what form?
ANS: UB04
Form that contains DOS, CPT, ICD codes, Fees and Copay information is called?
ANS: Encounter forms
,Anesthesia section of CPT manual which are considered qualifying circumstances?
ANS: Add-on codes
Patient presents with chest pain and shortness of breath with abnormal ECG the provider calls a
cardiologist. What portion of HIPPA allows this?
ANS: Title II
HIPPA compliance guidelines affecting EHR
ANS: Code set standard pertain to all providers
Color formats on CMS 1500 form acceptable
ANS: Red
Financial record generated by a provider office
ANS: Patient Ledger account
Which of the following includes procedures and best practices for correct coding
ANS: Coding Compliance Plan
Which of the following planes divides the body into left and right
ANS: Sagittal
3rd Party payer validates a claim which takes place next?
ANS: Claim adjudication: the term used in the industry to refer to the process of paying claims
submitted on denying them after comparing claims to the benefit or coverage requirements
, Developed to reduced Medicare program expenditure by detecting in appropriate codes and
eliminating improper coding
ANS: NCCI (National Correct Coding Initiative)
Beneficiary of Medicaid/Medicare crossover claim is responsible for the percentage
ANS: 0%
Which of the following steps would be party of a physicians practice compliance program
ANS: Internal monitoring and auditing
Which of the following acts applies to the administrative simplification guidelines?
ANS: HIPPA
Patient charges that have not been paid will appear in which of the following?
ANS: Accounts receivable
Which of the following is considered the final determination of the issues involving settlement of
an insurance claim?
ANS: Adjudication
A prospective billing account audit prevents fraud by reviewing and comparing a completed
claim with which of the following documents
ANS: A billing worksheet from the patient account
Missing or invalid patient identification number and lack of authorization or referral number
CODING EXAM 2025 QUESTIONS
AND 100% CORRECT ANSWERS
Billing and coding specialist should first divide the E/M code by
ANS: Place of Service
Complaint with HIPPA the following position should be assigned in each office
ANS: Privacy Officer
Coding on the UB-04 Form, must sequence the diagnosis code. Which is the first listed
diagnosis?
ANS: Principal Diagnosis
Obstruction of the urethra is?
ANS: Urethratresia
Ambulatory surgery centers, home health center, and hospice use what form?
ANS: UB04
Form that contains DOS, CPT, ICD codes, Fees and Copay information is called?
ANS: Encounter forms
,Anesthesia section of CPT manual which are considered qualifying circumstances?
ANS: Add-on codes
Patient presents with chest pain and shortness of breath with abnormal ECG the provider calls a
cardiologist. What portion of HIPPA allows this?
ANS: Title II
HIPPA compliance guidelines affecting EHR
ANS: Code set standard pertain to all providers
Color formats on CMS 1500 form acceptable
ANS: Red
Financial record generated by a provider office
ANS: Patient Ledger account
Which of the following includes procedures and best practices for correct coding
ANS: Coding Compliance Plan
Which of the following planes divides the body into left and right
ANS: Sagittal
3rd Party payer validates a claim which takes place next?
ANS: Claim adjudication: the term used in the industry to refer to the process of paying claims
submitted on denying them after comparing claims to the benefit or coverage requirements
, Developed to reduced Medicare program expenditure by detecting in appropriate codes and
eliminating improper coding
ANS: NCCI (National Correct Coding Initiative)
Beneficiary of Medicaid/Medicare crossover claim is responsible for the percentage
ANS: 0%
Which of the following steps would be party of a physicians practice compliance program
ANS: Internal monitoring and auditing
Which of the following acts applies to the administrative simplification guidelines?
ANS: HIPPA
Patient charges that have not been paid will appear in which of the following?
ANS: Accounts receivable
Which of the following is considered the final determination of the issues involving settlement of
an insurance claim?
ANS: Adjudication
A prospective billing account audit prevents fraud by reviewing and comparing a completed
claim with which of the following documents
ANS: A billing worksheet from the patient account
Missing or invalid patient identification number and lack of authorization or referral number
