NHA MEDICAL CODING AND BILLING
COMPREHENSIVE REVIEW STUDY GUIDE
TESTED QUESTIONS 2026 100% CORRECT.
⫸ What are considered qualifying circumstances in the anesthesia
section of the CPT manual? Answer: Add-on codes
⫸ As of April 1, 2014, 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
⫸ What is considered proper supportive documentation for reporting
CPT and ICD codes for surgical procedures? Answer: Operative
report
⫸ What is the first action to take when reviewing a delinquent claim?
Answer: Verify the age of the account
⫸ For which of the following reasons can a claim be denied or
rejected? Answer: Block 24D contains the diagnosis code
⫸ What examinations are comprised in a coroner's autopsy? Answer:
Gross Examination
,⫸ Who offers Medigap coverage to Medicare beneficiaries? Answer:
Private third-party payers
⫸ Which part of Medicare covers prescriptions? Answer: Part D
⫸ Which plane divides the body into left and right? Answer: Sagittal
⫸ Where are unlisted codes located in the CPT manual? Answer:
Guidelines prior to each section
⫸ What form do ambulatory surgery centers, home health care, and
hospice organizations use to submit claims? Answer: UB-04 Claim
Form
⫸ What color format is accepted on the CMS-1500 claim form?
Answer: Red
⫸ Who is responsible for paying the deductible? Answer: Patient
⫸ What is the patient's health plan referred to as the 'payer of last
resort'? Answer: Medicaid
⫸ Definition: Informed Consent Answer: Providers explain medical
procedures, surgical interventions, benefits, and risks to patients
before intervention.
, ⫸ Definition: Implied Consent Answer: Patient's actions imply
consent for treatment, e.g., extending an arm for venipuncture.
⫸ What is the role of a Clearinghouse in medical billing? Answer:
Converts claims to electronic format, checks for errors, and ensures
compliance with HIPAA and insurance standards.
⫸ What does 'Individually Identifiable' mean in healthcare
documentation? Answer: Information that can identify a person or
provide enough details for identification.
⫸ What is 'De-identified Information' in healthcare? Answer:
Information with personal characteristics removed, making it unable
to identify an individual.
⫸ Consent Answer: A patient's permission evidenced by signature.
⫸ Authorizations Answer: Permission granted by the patient or the
patient's representative for purposes other than treatment, payment, or
health care operations.
⫸ Reimbursement Answer: Payment for services provided by a third-
party payer.
⫸ Auditing Answer: Reviewing claims for accuracy and
completeness.
COMPREHENSIVE REVIEW STUDY GUIDE
TESTED QUESTIONS 2026 100% CORRECT.
⫸ What are considered qualifying circumstances in the anesthesia
section of the CPT manual? Answer: Add-on codes
⫸ As of April 1, 2014, 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
⫸ What is considered proper supportive documentation for reporting
CPT and ICD codes for surgical procedures? Answer: Operative
report
⫸ What is the first action to take when reviewing a delinquent claim?
Answer: Verify the age of the account
⫸ For which of the following reasons can a claim be denied or
rejected? Answer: Block 24D contains the diagnosis code
⫸ What examinations are comprised in a coroner's autopsy? Answer:
Gross Examination
,⫸ Who offers Medigap coverage to Medicare beneficiaries? Answer:
Private third-party payers
⫸ Which part of Medicare covers prescriptions? Answer: Part D
⫸ Which plane divides the body into left and right? Answer: Sagittal
⫸ Where are unlisted codes located in the CPT manual? Answer:
Guidelines prior to each section
⫸ What form do ambulatory surgery centers, home health care, and
hospice organizations use to submit claims? Answer: UB-04 Claim
Form
⫸ What color format is accepted on the CMS-1500 claim form?
Answer: Red
⫸ Who is responsible for paying the deductible? Answer: Patient
⫸ What is the patient's health plan referred to as the 'payer of last
resort'? Answer: Medicaid
⫸ Definition: Informed Consent Answer: Providers explain medical
procedures, surgical interventions, benefits, and risks to patients
before intervention.
, ⫸ Definition: Implied Consent Answer: Patient's actions imply
consent for treatment, e.g., extending an arm for venipuncture.
⫸ What is the role of a Clearinghouse in medical billing? Answer:
Converts claims to electronic format, checks for errors, and ensures
compliance with HIPAA and insurance standards.
⫸ What does 'Individually Identifiable' mean in healthcare
documentation? Answer: Information that can identify a person or
provide enough details for identification.
⫸ What is 'De-identified Information' in healthcare? Answer:
Information with personal characteristics removed, making it unable
to identify an individual.
⫸ Consent Answer: A patient's permission evidenced by signature.
⫸ Authorizations Answer: Permission granted by the patient or the
patient's representative for purposes other than treatment, payment, or
health care operations.
⫸ Reimbursement Answer: Payment for services provided by a third-
party payer.
⫸ Auditing Answer: Reviewing claims for accuracy and
completeness.
