2026 CBCS ACTUAL EXAMS SCRIPT QUESTIONS
AND ANSWERS SURE A+
✔✔Which of the following coding manuals is used to identify products, supplies and
services?
- ICD-10 manual (diagnosis codes)
- HCPCS level II manual
- ICD-10-PCS manual (inpatient facilities to assign procedures)
- CPT manual (outpatient professional service and procedure codes in an - ✔✔HCPCS
level II manual
- ICD-10 manual (diagnosis codes)
- ICD-10-PCS manual (inpatient facilities to assign procedures)
- CPT manual (outpatient professional service and procedure codes in an
✔✔A patient has an emergency appendectomy while on vacation. The claim is rejected
due to the patient obtaining services out of network. Which of the following information
should be included in the claim appeal?
- The provider's network status
- The names of the travelers who where with the patient during the emergency
- The patient was out of town during the emergency
- The reason why the patient was out of town - ✔✔The patient was out of town during
the emergency
✔✔After reading a provider's notes about a new patient, a CBCS decides to code for a
longer length of time than the actual office visit. Which of the following describes that
action?
- Unbundling
- Abuse
- Fraud
- Error - ✔✔fraud
✔✔Two providers from the same practice visit a patient in the ER using the same CPT
code. The claim may be denied due to which of the following reasons?
,- Continuity of care
- Incident to service (non physician practitioner bills in place of the physician)
- Critical care
- Duplication of services - ✔✔duplication of service
✔✔Which of the following statements is true when determining patient financial
responsibility by reviewing the remittance advice?
- Any service not paid by a third party payer
- Any coinsurance, copayment, deductions
- The difference between the billed amount and the allowed amount
- claims not billed to a third party payer within the correct time period - ✔✔Any
coinsurance, copayment, deductions
✔✔Which of the following is a requirement of some third party payers before a
procedure is performed?
- Predetermination form
- Pre Authorization form
- Advanced beneficiary notice
- Precertification form - ✔✔Pre Authorization form
✔✔Which of the following modifiers should be used to include a professional service
has been discontinued prior to completion?
-73 (used by facilities to indicate a discontinued outpatient procedure prior to procedure)
-52 ( physician to indicate that a service code was reduced from its original description)
-74 ( facilities to indicate a discontinued outpatient procedure after the procedure)
-53 (physician uses this for a procedure begun but discontinued prior to its completion) -
✔✔53 (physician uses this for a procedure begun but discontinued prior to its
completion)
- 73 (used by facilities to indicate a discontinued outpatient procedure prior to
procedure)
-52 ( physician to indicate that a service code was reduced from its original description)
-74 ( facilities to indicate a discontinued outpatient procedure after the procedure)
✔✔Which of the following is used by providers to remove errors from claims before they
are submitted to third party payers?
- National committee for quality assurance
- HIPAA transaction and code sets (TCS)
- Correct coding initiative (CCI)
- clearinghouse - ✔✔clearinghouse
- National committee for quality assurance (report standards that compare performance
between health care plans)
- HIPAA transaction and code sets (TCS) (standardizes electronic claim transactions)
- Correct coding initiative (CCI) ( prevents unbundling)
✔✔Block 17b should list which of the following information?
,- Referring physician's national provider identification number
- Referring physicians name
- Rendering physician's national provider identification number
- Rendering physician's name - ✔✔Referring physician's national provider identification
number
- Referring physicians name (block 31)
- Rendering physician's national provider identification number (24i)
- Rendering physician's name (17)
✔✔Which of the following is the third stage of the life cycle of a claim?
- Claim processing
- Claims payment
- Claims adjudication
- Claims submission - ✔✔Claims adjudication
- Claim processing (second)
- Claims payment ( fourth)
- Claims submission (first)
✔✔A patient presents to the provider with chest pain and shortness of breath. After an
unexpected ECG result, the provider calls a cardiologist and summarizes the patient's
symptoms. What portion of HIPAA allows the provider to speak to the cardiologist prior
to obtaining the patient's consent?
- Title I
- The privacy rule
- Title II
- FERPA - ✔✔Title II
- Title I (regulates insurance reform)
- The privacy rule
- FERPA ( family education right and privacy act = protects the privacy of student
records, not part of HIPAA)
✔✔When a physician documents a patient's response to symptoms and various body
systems. The results are documented as which of the following?
- Past medical history
- Family history
- Review of systems
- Comprehensive examination - ✔✔Review of systems
✔✔Which of the following statements is true regarding the release of patient records?
- Verbal requests for records from life insurance companies are appropriate
- Identification is not required when requesting access to patient records
- Providers cannot share a patient' medical information with other health care
professionals if the patient's mentally unstable
- Patient access to psychotherapy notes may be restricted - ✔✔Patient access to
psychotherapy notes may be restricted
, ✔✔A claim is denied because the service was not covered by the insurance. Upon
confirmation of no errors on the claim, which of the following describes the process that
will follow the denial?
- The claim will be submitted with a new CPT code
- The claim will not be resubmitted and the patient will be sent a bill
- The claim will be resubmitted with a modifier on the CPT code
- The claim will not be resubmitted, but the claim will be appealed. - ✔✔The claim will
not be resubmitted and the patient will be sent a bill
✔✔When an electronic claim is rejected due to incomplete information, which of the
following action should the CBCS take?
- Process the claim as an adjustment
- Complete the information and retransmit according to the third party standards
- Reprocess the rejected claim within 30 days
- Send the claim back with the next batch of claims - ✔✔Complete the information and
retransmit according to the third party standards
✔✔Which of the following documents is required to disclose an adult patient's
information
- A signed released for the patient's family member
- The patient's driver's license
- A signed release from the patient
- The patient's social security card - ✔✔A signed release from the patient
✔✔In 1995 and 1997 , which of the following introduced documentation guidelines to
Medicare carriers to ensure that service paid for have been provided and were
medically necessary?
- HIPAA
- OIG
- CMS
- AMA - ✔✔CMS
- OIG - fraud and abuse
- AMA - physician patient relationship
✔✔For which of the following time periods should the CBCS track unpaid claims before
taking follow up action?
10 days
30 days
60 days
90 days - ✔✔30 days
✔✔A beneficiary of a Medicare/Medicaid crossover claim submitted by a participating
provider is responsible for which of the following percentage?
40%
AND ANSWERS SURE A+
✔✔Which of the following coding manuals is used to identify products, supplies and
services?
- ICD-10 manual (diagnosis codes)
- HCPCS level II manual
- ICD-10-PCS manual (inpatient facilities to assign procedures)
- CPT manual (outpatient professional service and procedure codes in an - ✔✔HCPCS
level II manual
- ICD-10 manual (diagnosis codes)
- ICD-10-PCS manual (inpatient facilities to assign procedures)
- CPT manual (outpatient professional service and procedure codes in an
✔✔A patient has an emergency appendectomy while on vacation. The claim is rejected
due to the patient obtaining services out of network. Which of the following information
should be included in the claim appeal?
- The provider's network status
- The names of the travelers who where with the patient during the emergency
- The patient was out of town during the emergency
- The reason why the patient was out of town - ✔✔The patient was out of town during
the emergency
✔✔After reading a provider's notes about a new patient, a CBCS decides to code for a
longer length of time than the actual office visit. Which of the following describes that
action?
- Unbundling
- Abuse
- Fraud
- Error - ✔✔fraud
✔✔Two providers from the same practice visit a patient in the ER using the same CPT
code. The claim may be denied due to which of the following reasons?
,- Continuity of care
- Incident to service (non physician practitioner bills in place of the physician)
- Critical care
- Duplication of services - ✔✔duplication of service
✔✔Which of the following statements is true when determining patient financial
responsibility by reviewing the remittance advice?
- Any service not paid by a third party payer
- Any coinsurance, copayment, deductions
- The difference between the billed amount and the allowed amount
- claims not billed to a third party payer within the correct time period - ✔✔Any
coinsurance, copayment, deductions
✔✔Which of the following is a requirement of some third party payers before a
procedure is performed?
- Predetermination form
- Pre Authorization form
- Advanced beneficiary notice
- Precertification form - ✔✔Pre Authorization form
✔✔Which of the following modifiers should be used to include a professional service
has been discontinued prior to completion?
-73 (used by facilities to indicate a discontinued outpatient procedure prior to procedure)
-52 ( physician to indicate that a service code was reduced from its original description)
-74 ( facilities to indicate a discontinued outpatient procedure after the procedure)
-53 (physician uses this for a procedure begun but discontinued prior to its completion) -
✔✔53 (physician uses this for a procedure begun but discontinued prior to its
completion)
- 73 (used by facilities to indicate a discontinued outpatient procedure prior to
procedure)
-52 ( physician to indicate that a service code was reduced from its original description)
-74 ( facilities to indicate a discontinued outpatient procedure after the procedure)
✔✔Which of the following is used by providers to remove errors from claims before they
are submitted to third party payers?
- National committee for quality assurance
- HIPAA transaction and code sets (TCS)
- Correct coding initiative (CCI)
- clearinghouse - ✔✔clearinghouse
- National committee for quality assurance (report standards that compare performance
between health care plans)
- HIPAA transaction and code sets (TCS) (standardizes electronic claim transactions)
- Correct coding initiative (CCI) ( prevents unbundling)
✔✔Block 17b should list which of the following information?
,- Referring physician's national provider identification number
- Referring physicians name
- Rendering physician's national provider identification number
- Rendering physician's name - ✔✔Referring physician's national provider identification
number
- Referring physicians name (block 31)
- Rendering physician's national provider identification number (24i)
- Rendering physician's name (17)
✔✔Which of the following is the third stage of the life cycle of a claim?
- Claim processing
- Claims payment
- Claims adjudication
- Claims submission - ✔✔Claims adjudication
- Claim processing (second)
- Claims payment ( fourth)
- Claims submission (first)
✔✔A patient presents to the provider with chest pain and shortness of breath. After an
unexpected ECG result, the provider calls a cardiologist and summarizes the patient's
symptoms. What portion of HIPAA allows the provider to speak to the cardiologist prior
to obtaining the patient's consent?
- Title I
- The privacy rule
- Title II
- FERPA - ✔✔Title II
- Title I (regulates insurance reform)
- The privacy rule
- FERPA ( family education right and privacy act = protects the privacy of student
records, not part of HIPAA)
✔✔When a physician documents a patient's response to symptoms and various body
systems. The results are documented as which of the following?
- Past medical history
- Family history
- Review of systems
- Comprehensive examination - ✔✔Review of systems
✔✔Which of the following statements is true regarding the release of patient records?
- Verbal requests for records from life insurance companies are appropriate
- Identification is not required when requesting access to patient records
- Providers cannot share a patient' medical information with other health care
professionals if the patient's mentally unstable
- Patient access to psychotherapy notes may be restricted - ✔✔Patient access to
psychotherapy notes may be restricted
, ✔✔A claim is denied because the service was not covered by the insurance. Upon
confirmation of no errors on the claim, which of the following describes the process that
will follow the denial?
- The claim will be submitted with a new CPT code
- The claim will not be resubmitted and the patient will be sent a bill
- The claim will be resubmitted with a modifier on the CPT code
- The claim will not be resubmitted, but the claim will be appealed. - ✔✔The claim will
not be resubmitted and the patient will be sent a bill
✔✔When an electronic claim is rejected due to incomplete information, which of the
following action should the CBCS take?
- Process the claim as an adjustment
- Complete the information and retransmit according to the third party standards
- Reprocess the rejected claim within 30 days
- Send the claim back with the next batch of claims - ✔✔Complete the information and
retransmit according to the third party standards
✔✔Which of the following documents is required to disclose an adult patient's
information
- A signed released for the patient's family member
- The patient's driver's license
- A signed release from the patient
- The patient's social security card - ✔✔A signed release from the patient
✔✔In 1995 and 1997 , which of the following introduced documentation guidelines to
Medicare carriers to ensure that service paid for have been provided and were
medically necessary?
- HIPAA
- OIG
- CMS
- AMA - ✔✔CMS
- OIG - fraud and abuse
- AMA - physician patient relationship
✔✔For which of the following time periods should the CBCS track unpaid claims before
taking follow up action?
10 days
30 days
60 days
90 days - ✔✔30 days
✔✔A beneficiary of a Medicare/Medicaid crossover claim submitted by a participating
provider is responsible for which of the following percentage?
40%
