CBCS PRACTICE TEST
1. Missing #1 - Answer -BLANK
2. A claim is submitted with a transposed insurance member ID number & returned to the provider. This
describes the status that should be assigned to the claim by the carrier? - Answer -INVALID
3. Medigap coverage is offered to Medicare beneficiaries by? - Answer -PRIVATE THIRD-PARTY PAYER
4. This provision ensures that an insured's benefits from all insurance companies does not exceed 100%
of allowable medical - Answer -Coordination of benefits
5. A coroner's autopsy is comprised of which examination? - Answer -Gross examination.
6. This statement is true regarding the release of patient records? - Answer -Patient access to
psychotherapy notes may be restricted.
7. Actions by a billing & coding specialist would be considered fraud? - Answer -Billing for services not
provided.
8. The components of an explanation of benefits expedites the process of a phone appeal? - Answer -
Claim control number.
,9. On the CMS-1500 claim form, blocks 14 through 33 contain information of?. - Answer -The patient's
condition & the provider's information
10. A billing & coding specialist should understand that the financial record source that is generated by a
provider's office is called a? - Answer -Patient Ledger Account.
11. The medical terms refer to the sac that endoses the heart? - Answer -Pericardium.
12. HIPAA transaction standards apply to? - Answer -Health care clearinghouse.
13. All dependents 10 years of age or older are required to have which of the following for TRICARE? -
Answer -Military identification.
14. The standard medical abbreviation "ECG" refers to a test used to assess? - Answer -Cardiovascular
system.
15. An example of a violation of an adult patient's confidentiality? - Answer -Patient information was
disclosed to the patient's parent without consent.
16. Claims that are submitted without an NPI number will delay payment to the provider because? -
Answer -the number is needed to identify the provider
17. Sections of the medical record is used to determine the correct Evaluation & Management code
used for billing & coding? - Answer -History & physical
18. Actions should be taken if an insurance company denies a service as not medically necessary? -
Answer -Appeal the decision with a provider's report.
19. Missing #19 - Answer -misssing
20. The function of the respiratory system? - Answer -Oxygenating blood cells
, 21. This describes a delinquent claim? - Answer -The claim is overdue for payment.
22. What actions should the billing & coding specialist take if he observes a colleague in an unethical
situation? - Answer -Report the incident to a supervisor.
23. A participating Blue Cross/Blue Shield (BC/BS) provider receives an explanation of benefits for a
patient account. The charged amount was $100. BC/BS allowed $80 & applied $40 to the patient's
annual deductible. BC/BS paid the balance at 80%. How much should the patient expect to pay? -
Answer -$48.
24. This statement is correct regarding a deductible? - Answer -The deductible is the patient's
responsibility.
25. A physician ordered a comprehensive metabolic panel for a 70-year-old patient who has Medicare as
her primary insurance. This form is required so the patient knows she may be responsible for payment?
- Answer -Advance Beneficiary Notice.
26. What is the purpose of precertification? - Answer -Verification of coverage.
27. What claims is submitted & then optically scanned by the insurance carrier & converted to an
electronic form? - Answer -Paper claim
28. What information is required on a patient account record? - Answer -Name & address of guarantor.
29. This includes procedures & best practices for correct coding? - Answer -Coding Compliance Plan.
30. A patient who has a primary malignant neoplasm of the lung should be referred to ? - Answer -
Pulmonary oncologist
31. ICD-9-CM codes describes the circumstances of a patient who sustained an accidental fracture of the
proximal tibia? - Answer -E887 Fracture, cause unspecified.
1. Missing #1 - Answer -BLANK
2. A claim is submitted with a transposed insurance member ID number & returned to the provider. This
describes the status that should be assigned to the claim by the carrier? - Answer -INVALID
3. Medigap coverage is offered to Medicare beneficiaries by? - Answer -PRIVATE THIRD-PARTY PAYER
4. This provision ensures that an insured's benefits from all insurance companies does not exceed 100%
of allowable medical - Answer -Coordination of benefits
5. A coroner's autopsy is comprised of which examination? - Answer -Gross examination.
6. This statement is true regarding the release of patient records? - Answer -Patient access to
psychotherapy notes may be restricted.
7. Actions by a billing & coding specialist would be considered fraud? - Answer -Billing for services not
provided.
8. The components of an explanation of benefits expedites the process of a phone appeal? - Answer -
Claim control number.
,9. On the CMS-1500 claim form, blocks 14 through 33 contain information of?. - Answer -The patient's
condition & the provider's information
10. A billing & coding specialist should understand that the financial record source that is generated by a
provider's office is called a? - Answer -Patient Ledger Account.
11. The medical terms refer to the sac that endoses the heart? - Answer -Pericardium.
12. HIPAA transaction standards apply to? - Answer -Health care clearinghouse.
13. All dependents 10 years of age or older are required to have which of the following for TRICARE? -
Answer -Military identification.
14. The standard medical abbreviation "ECG" refers to a test used to assess? - Answer -Cardiovascular
system.
15. An example of a violation of an adult patient's confidentiality? - Answer -Patient information was
disclosed to the patient's parent without consent.
16. Claims that are submitted without an NPI number will delay payment to the provider because? -
Answer -the number is needed to identify the provider
17. Sections of the medical record is used to determine the correct Evaluation & Management code
used for billing & coding? - Answer -History & physical
18. Actions should be taken if an insurance company denies a service as not medically necessary? -
Answer -Appeal the decision with a provider's report.
19. Missing #19 - Answer -misssing
20. The function of the respiratory system? - Answer -Oxygenating blood cells
, 21. This describes a delinquent claim? - Answer -The claim is overdue for payment.
22. What actions should the billing & coding specialist take if he observes a colleague in an unethical
situation? - Answer -Report the incident to a supervisor.
23. A participating Blue Cross/Blue Shield (BC/BS) provider receives an explanation of benefits for a
patient account. The charged amount was $100. BC/BS allowed $80 & applied $40 to the patient's
annual deductible. BC/BS paid the balance at 80%. How much should the patient expect to pay? -
Answer -$48.
24. This statement is correct regarding a deductible? - Answer -The deductible is the patient's
responsibility.
25. A physician ordered a comprehensive metabolic panel for a 70-year-old patient who has Medicare as
her primary insurance. This form is required so the patient knows she may be responsible for payment?
- Answer -Advance Beneficiary Notice.
26. What is the purpose of precertification? - Answer -Verification of coverage.
27. What claims is submitted & then optically scanned by the insurance carrier & converted to an
electronic form? - Answer -Paper claim
28. What information is required on a patient account record? - Answer -Name & address of guarantor.
29. This includes procedures & best practices for correct coding? - Answer -Coding Compliance Plan.
30. A patient who has a primary malignant neoplasm of the lung should be referred to ? - Answer -
Pulmonary oncologist
31. ICD-9-CM codes describes the circumstances of a patient who sustained an accidental fracture of the
proximal tibia? - Answer -E887 Fracture, cause unspecified.
