4/12/25, 8:27
PM
CBCS PRACTICE FOR NHA 2025 EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
5.0 (1 review)
Save
Students also studied
Flashcard sets Study guides Practice tests
15 terms 106 terms Teacher10 terms
9t
Preview Preview Preview
Practice questions for this set
Learn 1/7 Study using Learn
What is considered proper supportive documentation for reporting CPT and ICD codes
for surgical procedures?
Select the correct term
1Aging Report 2History And Physical
3Operative Report 4Encounter Form
Don't know?
Terms in this set (170)
The symbol "O" in the Current Procedural Terminology reference is used to
Reinstated or recycled code
indicate what?
In the anesthesia section of the CPT manual, what are considered qualifying
Add-on codes
circumstances?
What is considered proper supportive documentation for reporting CPT and ICD
Operative Report
codes for surgical procedures?
Guidelines prior to each section Where can unlisted codes be found in the CPT manual.
17b Where does the NPI number go on the CMS-1500 form?
https://quizlet.com/408486868/cbcs-practice-for-nha-2019- 1/
flash-cards/ 5
, 4/12/25, 8:27
PM
Electronic Data Interchange The transfer of electronic information in a standard form.
Explanation of Benefits (EOB) Describes the services rendered, payment covered, and benefit limits and denials.
Crossover Claim Claim submitted by people covered by a primary and secondary insurance plan.
Authorizes the release of medical By signing block 12 of CMS-1500 form, a patient is doing what?
information.
Medicare Part A Provides hospitalization insurance to eligible individuals.
Voluntary supplemental medical insurance to help pay for physicians' and
Medicare Part B other medical professionals' services, medical services, and medical-surgical
supplies not covered by Medicare Part A.
Combined package of benefits under Medicare Parts A and B that may offer extra
Medicare Advantage (MA) coverage for services such as vision, hearing, dental, health and wellness, or
prescription drug coverage.
Medicare Part D prescription drug coverage by Medicare
A private health insurance that pays for most of the charges not covered by
Medigap
Medicare Parts A and B.
PreAUTHORIZATION Approval from the health plan for an inpatient hospital stay or surgery.
A review that looks at whether the procedure could be performed safely but less
PreCERTIFICATION
expensively in an outpatient setting.
PreDETERMINATION A written request for a verification of benefits.
Who is usually the Gatekeeper? The primary physician.
Formulary A list of prescription drugs covered by an insurance plan.
Tier 1 Providers and facilities in a PPO's network.
Providers and facilities within a broader, contracted network of the insurance
Tier 2
company.
Tier 3 Providers and facilities out of the network.
Tier 4 Providers and facilities not on the formulary.
Preferred Provider Tier 2 provider
Information about health care services that patients have received and financial
Charge Description Master (CDM)
transactions that have taken place.
Balance Billing Billing patients for charges in excess of the Medicare fee schedule.
Batch A group of submitted claims.
Codes used to classify visits when circumstances other than disease or injury are
V Codes
the reason for the appointment.
Codes used to classify environmental events, circumstances, and conditions, such
E Codes
as the cause of injury, poisoning, and other adverse events.
Category 1 CPT Code Code that covers physicians' services and hospital outpatient coding.
Code designed to serve as supplemental tracking codes that can be used for
Category 2 CPT Code
performance measurement.
Code used for temporary coding for new technology and services that have not
Category 3 CPT Code
met the requirements needed to be added to the main section of the CPT book.
The extraction of specific data from a medical record, often for use in an external
Abstracting
database, such as a cancer registry.
Encoder Software that suggests codes based on documentation or other input.
Software that helps coders assign the appropriate Medicare severity diagnosis-
MS-DRG Grouper related group based on the level of services provided, severity of the illness or
injury, and other factors.
https://quizlet.com/408486868/cbcs-practice-for-nha-2019- 2/
flash-cards/ 5
PM
CBCS PRACTICE FOR NHA 2025 EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
5.0 (1 review)
Save
Students also studied
Flashcard sets Study guides Practice tests
15 terms 106 terms Teacher10 terms
9t
Preview Preview Preview
Practice questions for this set
Learn 1/7 Study using Learn
What is considered proper supportive documentation for reporting CPT and ICD codes
for surgical procedures?
Select the correct term
1Aging Report 2History And Physical
3Operative Report 4Encounter Form
Don't know?
Terms in this set (170)
The symbol "O" in the Current Procedural Terminology reference is used to
Reinstated or recycled code
indicate what?
In the anesthesia section of the CPT manual, what are considered qualifying
Add-on codes
circumstances?
What is considered proper supportive documentation for reporting CPT and ICD
Operative Report
codes for surgical procedures?
Guidelines prior to each section Where can unlisted codes be found in the CPT manual.
17b Where does the NPI number go on the CMS-1500 form?
https://quizlet.com/408486868/cbcs-practice-for-nha-2019- 1/
flash-cards/ 5
, 4/12/25, 8:27
PM
Electronic Data Interchange The transfer of electronic information in a standard form.
Explanation of Benefits (EOB) Describes the services rendered, payment covered, and benefit limits and denials.
Crossover Claim Claim submitted by people covered by a primary and secondary insurance plan.
Authorizes the release of medical By signing block 12 of CMS-1500 form, a patient is doing what?
information.
Medicare Part A Provides hospitalization insurance to eligible individuals.
Voluntary supplemental medical insurance to help pay for physicians' and
Medicare Part B other medical professionals' services, medical services, and medical-surgical
supplies not covered by Medicare Part A.
Combined package of benefits under Medicare Parts A and B that may offer extra
Medicare Advantage (MA) coverage for services such as vision, hearing, dental, health and wellness, or
prescription drug coverage.
Medicare Part D prescription drug coverage by Medicare
A private health insurance that pays for most of the charges not covered by
Medigap
Medicare Parts A and B.
PreAUTHORIZATION Approval from the health plan for an inpatient hospital stay or surgery.
A review that looks at whether the procedure could be performed safely but less
PreCERTIFICATION
expensively in an outpatient setting.
PreDETERMINATION A written request for a verification of benefits.
Who is usually the Gatekeeper? The primary physician.
Formulary A list of prescription drugs covered by an insurance plan.
Tier 1 Providers and facilities in a PPO's network.
Providers and facilities within a broader, contracted network of the insurance
Tier 2
company.
Tier 3 Providers and facilities out of the network.
Tier 4 Providers and facilities not on the formulary.
Preferred Provider Tier 2 provider
Information about health care services that patients have received and financial
Charge Description Master (CDM)
transactions that have taken place.
Balance Billing Billing patients for charges in excess of the Medicare fee schedule.
Batch A group of submitted claims.
Codes used to classify visits when circumstances other than disease or injury are
V Codes
the reason for the appointment.
Codes used to classify environmental events, circumstances, and conditions, such
E Codes
as the cause of injury, poisoning, and other adverse events.
Category 1 CPT Code Code that covers physicians' services and hospital outpatient coding.
Code designed to serve as supplemental tracking codes that can be used for
Category 2 CPT Code
performance measurement.
Code used for temporary coding for new technology and services that have not
Category 3 CPT Code
met the requirements needed to be added to the main section of the CPT book.
The extraction of specific data from a medical record, often for use in an external
Abstracting
database, such as a cancer registry.
Encoder Software that suggests codes based on documentation or other input.
Software that helps coders assign the appropriate Medicare severity diagnosis-
MS-DRG Grouper related group based on the level of services provided, severity of the illness or
injury, and other factors.
https://quizlet.com/408486868/cbcs-practice-for-nha-2019- 2/
flash-cards/ 5
