Certified Professional Biller (CPB) Practice Exam
Questions and Answers 2025 – Full Review Set (1–100)
1. What is the primary purpose of medical billing?
A) To diagnose a patient
B) To collect demographic information
C) To submit claims and collect reimbursement for healthcare services
D) To determine treatment options
Answer: C
Explanation: Medical billing ensures healthcare providers receive
payment for services rendered by submitting claims to insurance
companies.
2. What does CPT stand for?
A) Certified Provider Technician
B) Current Procedural Terminology
C) Clinical Practice Test
D) Claims Processing Tool
,Answer: B
Explanation: CPT is a coding system used to describe medical, surgical,
and diagnostic services.
3. Which code set is used to report diagnoses?
A) CPT
B) ICD-10-CM
C) HCPCS Level II
D) DRG
Answer: B
Explanation: ICD-10-CM codes are used to describe patient diagnoses.
4. What is the purpose of HIPAA in billing?
A) Prevents insurance audits
B) Controls medical pricing
C) Protects patient privacy and standardizes electronic healthcare
transactions
D) Requires patient payment before treatment
Answer: C
,Explanation: HIPAA ensures privacy of health information and sets
standards for electronic billing and data exchange.
5. Which part of Medicare covers inpatient hospital services?
A) Part A
B) Part B
C) Part C
D) Part D
Answer: A
Explanation: Medicare Part A covers hospital stays, skilled nursing
facilities, and some home healthcare services.
6. What is a clean claim?
A) A claim that has been denied due to incorrect coding
B) A claim submitted on paper with a handwritten signature
C) A claim that is free of errors and processed without delays
D) A claim submitted after the filing deadline
Answer: C
, Explanation: A clean claim is one that is complete, accurate, and
submitted within the appropriate time frame, allowing it to be
processed without manual intervention.
7. What is the purpose of the CMS-1500 form?
A) To submit inpatient facility claims
B) To bill for dental services
C) To bill professional and outpatient services
D) To submit Medicare Part D claims
Answer: C
Explanation: The CMS-1500 form is used to bill Medicare and other
health insurance programs for outpatient and professional medical
services.
8. Which organization is responsible for issuing National Coverage
Determinations (NCDs)?
A) AMA
B) HIPAA
C) CMS
D) OIG
Answer: C
Questions and Answers 2025 – Full Review Set (1–100)
1. What is the primary purpose of medical billing?
A) To diagnose a patient
B) To collect demographic information
C) To submit claims and collect reimbursement for healthcare services
D) To determine treatment options
Answer: C
Explanation: Medical billing ensures healthcare providers receive
payment for services rendered by submitting claims to insurance
companies.
2. What does CPT stand for?
A) Certified Provider Technician
B) Current Procedural Terminology
C) Clinical Practice Test
D) Claims Processing Tool
,Answer: B
Explanation: CPT is a coding system used to describe medical, surgical,
and diagnostic services.
3. Which code set is used to report diagnoses?
A) CPT
B) ICD-10-CM
C) HCPCS Level II
D) DRG
Answer: B
Explanation: ICD-10-CM codes are used to describe patient diagnoses.
4. What is the purpose of HIPAA in billing?
A) Prevents insurance audits
B) Controls medical pricing
C) Protects patient privacy and standardizes electronic healthcare
transactions
D) Requires patient payment before treatment
Answer: C
,Explanation: HIPAA ensures privacy of health information and sets
standards for electronic billing and data exchange.
5. Which part of Medicare covers inpatient hospital services?
A) Part A
B) Part B
C) Part C
D) Part D
Answer: A
Explanation: Medicare Part A covers hospital stays, skilled nursing
facilities, and some home healthcare services.
6. What is a clean claim?
A) A claim that has been denied due to incorrect coding
B) A claim submitted on paper with a handwritten signature
C) A claim that is free of errors and processed without delays
D) A claim submitted after the filing deadline
Answer: C
, Explanation: A clean claim is one that is complete, accurate, and
submitted within the appropriate time frame, allowing it to be
processed without manual intervention.
7. What is the purpose of the CMS-1500 form?
A) To submit inpatient facility claims
B) To bill for dental services
C) To bill professional and outpatient services
D) To submit Medicare Part D claims
Answer: C
Explanation: The CMS-1500 form is used to bill Medicare and other
health insurance programs for outpatient and professional medical
services.
8. Which organization is responsible for issuing National Coverage
Determinations (NCDs)?
A) AMA
B) HIPAA
C) CMS
D) OIG
Answer: C
