NHA Billing and Coding practice test (CBCS)
The attending physician Correct Answer: A nurse is reviewing a patients lab results prior to discharge
and discovers an elevated glucose level. Which of the following health care providers should be altered
before the nurse can proceed with discharge planning?
The patients condition and the providers information Correct Answer: On the CMS-1500 Claims for,
blocks 14 through 33 contain information about which of the following?
Problem focused examination Correct Answer: A provider performs an examination of a patient's throat
during an office visit. Which of the following describes the level of the examination?
Reinstated or recycled code Correct Answer: The symbol "O" in the Current Procedural Terminology
reference is used to indicate which of the following?
Coinsurance Correct Answer: Which of the following is the portion of the account balance the patient
must pay after services are rendered and the annual deductible is met?
Place of service Correct Answer: The billing and coding specialist should divide the evaluation and
management code by which of the following?
Cardiovascular system Correct Answer: The standard medical abbreviation "ECG" refers to a test used
to access which of the following body systems?
add on codes Correct Answer: In the anesthesia section of the CPT manual, which of the following are
considered qualifying circumstances?
12 Correct Answer: As of April 1st 2014, what is the maximum number of diagnosis that can be reported
on the CMS-1500 claim form before a further claim is required?
Nephrolithiasis Correct Answer: When submitting a clean claim with a diagnosis of kidney stones, which
of the following procedure names is correct?
Verifying that the medical records and the billing record match Correct Answer: Which of the following
is one of the purposes of an internal auditing program in a physician's office?
The DOB is entered incorrectly Correct Answer: Patient: Jane Austin; Social Security # 555-22-1111;
Medicare ID: 555-33-2222A; DOB: 05/22/1945. Claim information entered: Austin, Jane; Social Security
#.: 555-22-1111; Medicare ID No.: 555-33-2222A; DOB: 052245. Which of the following is a reason this
claim was rejected?
Operative report Correct Answer: Which of the following options is considered proper supportive
documentation for reporting CPT and ICD codes for surgical procedures?
, Verify the age of the account Correct Answer: Which of the following actions should be taken first when
reviewing delinquent claims?
Claim control number Correct Answer: Which of the following components of an explanation of benefits
expedites the process of a phone appeal?
Bloc 24D contains the diagnosis code Correct Answer: A claim can be denied or rejected for which of the
following reasons?
Privacy officer Correct Answer: To be compliant with HIPAA, which of the following positions should be
assigned in each office?
encrypted Correct Answer: All e-mail correspondence to a third party payer containing patients'
protected health information (PHI) should be
patient ledger account Correct Answer: A billing and coding specialist should understand that the
financial record source that is generated by a provider's office is called a
Coding compliance plan Correct Answer: Which of the following includes procedures and best practices
for correct coding?
Health care clearinghouses Correct Answer: HIPAA transaction standards apply to which of the
following entities?
Appeal the decision with a provider's report Correct Answer: Which of the following actions should be
taken if an insurance company denies a service as not medically necessary?
Accommodate the request and send the records Correct Answer: A patient with a past due balance
requests that his records be sent to another provider. Which of the following actions should be taken?
$48 Correct Answer: A participating BlueCross/ BlueShield (BC/BS) provider receives an explanation of
benefits for a patient account. The charged amount was $100. BC/BS allowed $40 to the patients annual
deductible. BC/BS paid the balance at 80%. How much should the patient expect to pay?
Deductible Correct Answer: The physician bills $500 to a patient. After submitting the claim to the
insurance company, the claim is sent back with no payment. The patient still owes $500 for this year.
International Classification of Disease (ICD) Correct Answer: Which of the following is used to code
diseases, injuries, impairments, and other health related problems?
Ureters Correct Answer: Urine moves from the kidneys to the bladder through which of the following
parts of the body?
Angioplasty Correct Answer: Threading a catheter with a balloon into a coronary artery and expanding it
to repair arteries describes which of the following procedures?
The attending physician Correct Answer: A nurse is reviewing a patients lab results prior to discharge
and discovers an elevated glucose level. Which of the following health care providers should be altered
before the nurse can proceed with discharge planning?
The patients condition and the providers information Correct Answer: On the CMS-1500 Claims for,
blocks 14 through 33 contain information about which of the following?
Problem focused examination Correct Answer: A provider performs an examination of a patient's throat
during an office visit. Which of the following describes the level of the examination?
Reinstated or recycled code Correct Answer: The symbol "O" in the Current Procedural Terminology
reference is used to indicate which of the following?
Coinsurance Correct Answer: Which of the following is the portion of the account balance the patient
must pay after services are rendered and the annual deductible is met?
Place of service Correct Answer: The billing and coding specialist should divide the evaluation and
management code by which of the following?
Cardiovascular system Correct Answer: The standard medical abbreviation "ECG" refers to a test used
to access which of the following body systems?
add on codes Correct Answer: In the anesthesia section of the CPT manual, which of the following are
considered qualifying circumstances?
12 Correct Answer: As of April 1st 2014, what is the maximum number of diagnosis that can be reported
on the CMS-1500 claim form before a further claim is required?
Nephrolithiasis Correct Answer: When submitting a clean claim with a diagnosis of kidney stones, which
of the following procedure names is correct?
Verifying that the medical records and the billing record match Correct Answer: Which of the following
is one of the purposes of an internal auditing program in a physician's office?
The DOB is entered incorrectly Correct Answer: Patient: Jane Austin; Social Security # 555-22-1111;
Medicare ID: 555-33-2222A; DOB: 05/22/1945. Claim information entered: Austin, Jane; Social Security
#.: 555-22-1111; Medicare ID No.: 555-33-2222A; DOB: 052245. Which of the following is a reason this
claim was rejected?
Operative report Correct Answer: Which of the following options is considered proper supportive
documentation for reporting CPT and ICD codes for surgical procedures?
, Verify the age of the account Correct Answer: Which of the following actions should be taken first when
reviewing delinquent claims?
Claim control number Correct Answer: Which of the following components of an explanation of benefits
expedites the process of a phone appeal?
Bloc 24D contains the diagnosis code Correct Answer: A claim can be denied or rejected for which of the
following reasons?
Privacy officer Correct Answer: To be compliant with HIPAA, which of the following positions should be
assigned in each office?
encrypted Correct Answer: All e-mail correspondence to a third party payer containing patients'
protected health information (PHI) should be
patient ledger account Correct Answer: A billing and coding specialist should understand that the
financial record source that is generated by a provider's office is called a
Coding compliance plan Correct Answer: Which of the following includes procedures and best practices
for correct coding?
Health care clearinghouses Correct Answer: HIPAA transaction standards apply to which of the
following entities?
Appeal the decision with a provider's report Correct Answer: Which of the following actions should be
taken if an insurance company denies a service as not medically necessary?
Accommodate the request and send the records Correct Answer: A patient with a past due balance
requests that his records be sent to another provider. Which of the following actions should be taken?
$48 Correct Answer: A participating BlueCross/ BlueShield (BC/BS) provider receives an explanation of
benefits for a patient account. The charged amount was $100. BC/BS allowed $40 to the patients annual
deductible. BC/BS paid the balance at 80%. How much should the patient expect to pay?
Deductible Correct Answer: The physician bills $500 to a patient. After submitting the claim to the
insurance company, the claim is sent back with no payment. The patient still owes $500 for this year.
International Classification of Disease (ICD) Correct Answer: Which of the following is used to code
diseases, injuries, impairments, and other health related problems?
Ureters Correct Answer: Urine moves from the kidneys to the bladder through which of the following
parts of the body?
Angioplasty Correct Answer: Threading a catheter with a balloon into a coronary artery and expanding it
to repair arteries describes which of the following procedures?
