2026 UPDATED QUESTIONS DOWNLOAD
NHA CBCS Certification Exam Prep 2026/2027 | 350 High-Yield Questions &
Detailed Rationales | Certified Billing and Coding Specialist Mastery Bank
This comprehensive study resource features 350 high-yield practice questions specifically
designed to mirror the NHA CBCS (Certified Billing and Coding Specialist) exam blueprint.
Each question is paired with a detailed, italicized rationale covering CPT, ICD-10-CM, HCPCS
Level II, and HIPAA regulatory compliance. Perfectly formatted for active recall, this mastery
bank ensures you understand the "why" behind the codes and billing processes to secure your
certification on the first attempt.
NHA Billing and Coding Specialist (CBCS)
Practice Exam
1.
What does ICD-10-CM stand for?
A. International Coding Diagnosis, 10th Clinical Method
B. International Classification of Diseases, 10th Revision, Clinical Modification
C. Insurance Code Data, 10th Clinical Model
D. International Clinical Data, Version 10
Answer: B. International Classification of Diseases, 10th Revision, Clinical Modification
Rationale: ICD-10-CM is used for coding diagnoses in healthcare settings.
2.
What coding system is used for reporting medical procedures and services?
A. ICD-10-CM
B. CPT
C. HCPCS Level III
D. DRG
Answer: B. CPT
Rationale: Current Procedural Terminology (CPT) codes are used for procedures and services.
,2026 UPDATED QUESTIONS DOWNLOAD
3.
What does HIPAA stand for?
A. Health Insurance Patient Act Authority
B. Health Insurance Portability and Accountability Act
C. Health Information Privacy Act
D. Healthcare Insurance Privacy Act
Answer: B. Health Insurance Portability and Accountability Act
Rationale: HIPAA protects patient health information and ensures privacy.
4.
Which code set is used for supplies and equipment?
A. CPT
B. ICD-10-CM
C. HCPCS Level II
D. DRG
Answer: C. HCPCS Level II
Rationale: HCPCS Level II codes cover supplies, durable medical equipment, and services not
included in CPT.
5.
What is the purpose of medical coding?
A. Schedule appointments
B. Translate healthcare services into standardized codes
C. Provide patient care
D. Dispense medications
Answer: B. Translate healthcare services into standardized codes
Rationale: Coding converts medical documentation into universal codes for billing and records.
6.
,2026 UPDATED QUESTIONS DOWNLOAD
Which form is used to bill outpatient services?
A. UB-04
B. CMS-1500
C. W-2
D. EOB
Answer: B. CMS-1500
Rationale: CMS-1500 is used for physician and outpatient billing.
7.
What does EOB stand for?
A. Explanation of Benefits
B. Evidence of Billing
C. Evaluation of Benefits
D. Electronic Office Billing
Answer: A. Explanation of Benefits
Rationale: EOB explains what insurance covers and what the patient owes.
8.
What is upcoding?
A. Using outdated codes
B. Coding for a higher-level service than provided
C. Coding incorrectly by accident
D. Omitting codes
Answer: B. Coding for a higher-level service than provided
Rationale: Upcoding is fraudulent and increases reimbursement improperly.
9.
What is the purpose of a clearinghouse?
A. Store patient records
B. Process and transmit claims
, 2026 UPDATED QUESTIONS DOWNLOAD
C. Provide clinical care
D. Train staff
Answer: B. Process and transmit claims
Rationale: Clearinghouses review and forward claims to insurers.
10.
Which insurance program is for individuals 65 and older?
A. Medicaid
B. Medicare
C. TRICARE
D. Workers’ Compensation
Answer: B. Medicare
Rationale: Medicare provides coverage for elderly individuals.
11.
What is a deductible?
A. Monthly premium
B. Amount paid before insurance coverage begins
C. Total bill amount
D. Insurance reimbursement
Answer: B. Amount paid before insurance coverage begins
Rationale: Patients must meet the deductible before insurance pays.
12.
What does PHI stand for?
A. Personal Health Insurance
B. Protected Health Information
C. Public Health Insurance
D. Patient Health Index
NHA CBCS Certification Exam Prep 2026/2027 | 350 High-Yield Questions &
Detailed Rationales | Certified Billing and Coding Specialist Mastery Bank
This comprehensive study resource features 350 high-yield practice questions specifically
designed to mirror the NHA CBCS (Certified Billing and Coding Specialist) exam blueprint.
Each question is paired with a detailed, italicized rationale covering CPT, ICD-10-CM, HCPCS
Level II, and HIPAA regulatory compliance. Perfectly formatted for active recall, this mastery
bank ensures you understand the "why" behind the codes and billing processes to secure your
certification on the first attempt.
NHA Billing and Coding Specialist (CBCS)
Practice Exam
1.
What does ICD-10-CM stand for?
A. International Coding Diagnosis, 10th Clinical Method
B. International Classification of Diseases, 10th Revision, Clinical Modification
C. Insurance Code Data, 10th Clinical Model
D. International Clinical Data, Version 10
Answer: B. International Classification of Diseases, 10th Revision, Clinical Modification
Rationale: ICD-10-CM is used for coding diagnoses in healthcare settings.
2.
What coding system is used for reporting medical procedures and services?
A. ICD-10-CM
B. CPT
C. HCPCS Level III
D. DRG
Answer: B. CPT
Rationale: Current Procedural Terminology (CPT) codes are used for procedures and services.
,2026 UPDATED QUESTIONS DOWNLOAD
3.
What does HIPAA stand for?
A. Health Insurance Patient Act Authority
B. Health Insurance Portability and Accountability Act
C. Health Information Privacy Act
D. Healthcare Insurance Privacy Act
Answer: B. Health Insurance Portability and Accountability Act
Rationale: HIPAA protects patient health information and ensures privacy.
4.
Which code set is used for supplies and equipment?
A. CPT
B. ICD-10-CM
C. HCPCS Level II
D. DRG
Answer: C. HCPCS Level II
Rationale: HCPCS Level II codes cover supplies, durable medical equipment, and services not
included in CPT.
5.
What is the purpose of medical coding?
A. Schedule appointments
B. Translate healthcare services into standardized codes
C. Provide patient care
D. Dispense medications
Answer: B. Translate healthcare services into standardized codes
Rationale: Coding converts medical documentation into universal codes for billing and records.
6.
,2026 UPDATED QUESTIONS DOWNLOAD
Which form is used to bill outpatient services?
A. UB-04
B. CMS-1500
C. W-2
D. EOB
Answer: B. CMS-1500
Rationale: CMS-1500 is used for physician and outpatient billing.
7.
What does EOB stand for?
A. Explanation of Benefits
B. Evidence of Billing
C. Evaluation of Benefits
D. Electronic Office Billing
Answer: A. Explanation of Benefits
Rationale: EOB explains what insurance covers and what the patient owes.
8.
What is upcoding?
A. Using outdated codes
B. Coding for a higher-level service than provided
C. Coding incorrectly by accident
D. Omitting codes
Answer: B. Coding for a higher-level service than provided
Rationale: Upcoding is fraudulent and increases reimbursement improperly.
9.
What is the purpose of a clearinghouse?
A. Store patient records
B. Process and transmit claims
, 2026 UPDATED QUESTIONS DOWNLOAD
C. Provide clinical care
D. Train staff
Answer: B. Process and transmit claims
Rationale: Clearinghouses review and forward claims to insurers.
10.
Which insurance program is for individuals 65 and older?
A. Medicaid
B. Medicare
C. TRICARE
D. Workers’ Compensation
Answer: B. Medicare
Rationale: Medicare provides coverage for elderly individuals.
11.
What is a deductible?
A. Monthly premium
B. Amount paid before insurance coverage begins
C. Total bill amount
D. Insurance reimbursement
Answer: B. Amount paid before insurance coverage begins
Rationale: Patients must meet the deductible before insurance pays.
12.
What does PHI stand for?
A. Personal Health Insurance
B. Protected Health Information
C. Public Health Insurance
D. Patient Health Index
