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NHA CBCS EXAM QUESTIONS AND ANWERS WITH
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
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Terms in this set (159)
E Codes For durable medical equipment for use in home
Chief Complaint (CC) The reason the patient came to see the physician.
Consists of patients personal experiences with illnesses, surgeries, and injuries;
Past, Family and Social History (PFSH) Information of illnesses predominant in family; Patients educational background,
occupation, marital status and other factors
Used for procedures that are always performed during the same operative
Add on Codes session, as another surgery in addition to the primary service/procedure and is
never performed separately.
What act mandated the reporting of ICD- The Medicare Catastrophic Coverage Act of 1988
9-CM diagnosis codes?
Transmitting electronic medical insurance claims from providers to payers using
Electronic Data interchange (EDI)
the necessary information systems is called
Standards of conduct based on moral principals. Acting within ethical behavior
Medical Ethics are boundries means carrying out one's responsibilities with integrity, decency,
respect, honesty, competence, fairness and trust.
1. History
Three Components for E*M Codes 2. Physical Exam
3. Medical Decision-Making
At the beginning of each section and used to provide specific coding rules for
Guidelines are Found?
that section.
Co-payment A fixed fee collected at the time of the patients visit.
Appropriateness of Codes, Payers rules about linkage, Documentation to support
Review Linkage Protocol
codes, Compliance with regulation and guidelines
Involves restricting patient information access to those with proper
What is confidentiality?
authorization and maintaining the security of patient information.
What are the names of the three Hypertension Neoplasm Table of Drugs and Chemicals
tables that appear in the Index to
Diseases?
National codes for physician and non-physician service not found in the CPT Level
Level 2 codes
1
A/An_________is a person admitted to a hospital or long-term care facility(LTCF)
Inpatient for treatment with the expectation that the patient will remain in the hospital for
a period of 24 hours or more.
HIPAA is an acronym for Health Insurance Portability and Accountability Act of 1996.
Submission, Processing, Adjudication, Non-covered, Unauthorized, Medical
Life Cycle of a Claim
Necessity Checks, Payment / RA / ERA
Level 1 codes Codes found in the CPT manual
1/
5
, 4/12/25, 8:23 NHA CBCS Flashcards |
PM
The out-of-pocket payment amount that a policyholder must meet before
Deductible
insurance covers the service(s) is called?
A fixed percentage of covered charges applied to the patients bill after the
Coinsurance
deductible has been met.
Liability Insurance Covers injuries caused by insured that occurred on the insured's property.
"No notation of benign or malignant status is found in the diagnosis or in the
Unspecified
patient's chart."
A writ requiring the appearance of a person at a trial or other proceeding is a
subpoena
___________.
Medicare What is the single largest healthcare program in the United States?
Parentheses Used to enclose supplementary words; non essential modifiers
Health indemnity insurance is a fee for service insurance that is sometimes used
Indemnity insurance when a person is in between health plans, and will cover some (but not all)
expenses
A rejected claim is an electronically submitted claim that is unprocessable due
Rejected Claim
to missing or invalid information required by the payer.
77010 - 79999 Radiology
provide Medicaid to certain groups not otherwise eligible for Medicaid.must
cover:
• Pregnant women:
• Children under 18:
• States have option to cover:
Medicaid Medically Needy
• Children up to 21:
• Parents and other
caretaker relatives:
• Elderly:
• Individuals with disabilities:
Brackets Used to enclose synonyms, alternative wording or and explanatory phrase
Reporting indicators that indicate that the procedure or service has been altered
Modifiers
by specific circumstance but has not changed in it's definition of code.
Part A is hospital insurance provided by Medicare. Most people do not pay a
Medicare part A
premium for this coverage.
Part B is medical insurance to pay for medically necessary services and supplies
Medicare part B
provided by Medicare. (Doctors, outpatient care, Phys. and Occ. Therapists etc.)
Part C is the combination of Part A and Part B. The main difference in Part C is
Medicare part C
that it is provided through private insurance companies approved by
Medicare.
Medicare part D Part D is stand-alone prescription drug coverage insurance.
Health Maintenance Organization. A form of health insurance combining a range
of coverage's in a group basis. A group of doctors and other medical
HMO
professionals offer care through the HMO for a flat monthly rate with no
deductibles.
PPO is similar to an HMO, but care is paid for as received instead of in advance in
form of a schedule. PPOs may offer more flexibility by allowing for visits to out-of-
PPO
network professionals. Visits within network require only the payment of a small
fee.
A completed insurance claim form submitted with the program time limit that
Clean Claim contains all the necessary information without deficiencies so it can be processed
and paid promptly.
2/
5
PM
NHA CBCS EXAM QUESTIONS AND ANWERS WITH
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
5.0 (4 reviews)
Save
Terms in this set (159)
E Codes For durable medical equipment for use in home
Chief Complaint (CC) The reason the patient came to see the physician.
Consists of patients personal experiences with illnesses, surgeries, and injuries;
Past, Family and Social History (PFSH) Information of illnesses predominant in family; Patients educational background,
occupation, marital status and other factors
Used for procedures that are always performed during the same operative
Add on Codes session, as another surgery in addition to the primary service/procedure and is
never performed separately.
What act mandated the reporting of ICD- The Medicare Catastrophic Coverage Act of 1988
9-CM diagnosis codes?
Transmitting electronic medical insurance claims from providers to payers using
Electronic Data interchange (EDI)
the necessary information systems is called
Standards of conduct based on moral principals. Acting within ethical behavior
Medical Ethics are boundries means carrying out one's responsibilities with integrity, decency,
respect, honesty, competence, fairness and trust.
1. History
Three Components for E*M Codes 2. Physical Exam
3. Medical Decision-Making
At the beginning of each section and used to provide specific coding rules for
Guidelines are Found?
that section.
Co-payment A fixed fee collected at the time of the patients visit.
Appropriateness of Codes, Payers rules about linkage, Documentation to support
Review Linkage Protocol
codes, Compliance with regulation and guidelines
Involves restricting patient information access to those with proper
What is confidentiality?
authorization and maintaining the security of patient information.
What are the names of the three Hypertension Neoplasm Table of Drugs and Chemicals
tables that appear in the Index to
Diseases?
National codes for physician and non-physician service not found in the CPT Level
Level 2 codes
1
A/An_________is a person admitted to a hospital or long-term care facility(LTCF)
Inpatient for treatment with the expectation that the patient will remain in the hospital for
a period of 24 hours or more.
HIPAA is an acronym for Health Insurance Portability and Accountability Act of 1996.
Submission, Processing, Adjudication, Non-covered, Unauthorized, Medical
Life Cycle of a Claim
Necessity Checks, Payment / RA / ERA
Level 1 codes Codes found in the CPT manual
1/
5
, 4/12/25, 8:23 NHA CBCS Flashcards |
PM
The out-of-pocket payment amount that a policyholder must meet before
Deductible
insurance covers the service(s) is called?
A fixed percentage of covered charges applied to the patients bill after the
Coinsurance
deductible has been met.
Liability Insurance Covers injuries caused by insured that occurred on the insured's property.
"No notation of benign or malignant status is found in the diagnosis or in the
Unspecified
patient's chart."
A writ requiring the appearance of a person at a trial or other proceeding is a
subpoena
___________.
Medicare What is the single largest healthcare program in the United States?
Parentheses Used to enclose supplementary words; non essential modifiers
Health indemnity insurance is a fee for service insurance that is sometimes used
Indemnity insurance when a person is in between health plans, and will cover some (but not all)
expenses
A rejected claim is an electronically submitted claim that is unprocessable due
Rejected Claim
to missing or invalid information required by the payer.
77010 - 79999 Radiology
provide Medicaid to certain groups not otherwise eligible for Medicaid.must
cover:
• Pregnant women:
• Children under 18:
• States have option to cover:
Medicaid Medically Needy
• Children up to 21:
• Parents and other
caretaker relatives:
• Elderly:
• Individuals with disabilities:
Brackets Used to enclose synonyms, alternative wording or and explanatory phrase
Reporting indicators that indicate that the procedure or service has been altered
Modifiers
by specific circumstance but has not changed in it's definition of code.
Part A is hospital insurance provided by Medicare. Most people do not pay a
Medicare part A
premium for this coverage.
Part B is medical insurance to pay for medically necessary services and supplies
Medicare part B
provided by Medicare. (Doctors, outpatient care, Phys. and Occ. Therapists etc.)
Part C is the combination of Part A and Part B. The main difference in Part C is
Medicare part C
that it is provided through private insurance companies approved by
Medicare.
Medicare part D Part D is stand-alone prescription drug coverage insurance.
Health Maintenance Organization. A form of health insurance combining a range
of coverage's in a group basis. A group of doctors and other medical
HMO
professionals offer care through the HMO for a flat monthly rate with no
deductibles.
PPO is similar to an HMO, but care is paid for as received instead of in advance in
form of a schedule. PPOs may offer more flexibility by allowing for visits to out-of-
PPO
network professionals. Visits within network require only the payment of a small
fee.
A completed insurance claim form submitted with the program time limit that
Clean Claim contains all the necessary information without deficiencies so it can be processed
and paid promptly.
2/
5
