CBCS PRACTICE TEST EXAM 2025. (CORRECT ANSWERS).

CBCS PRACTICE TEST EXAM 2025.
(CORRECT ANSWERS)




1. Missing #1 - correct answer BLANK
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2. A claim is submitted with a transposed insurance member ID number & returned to the provider. This
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describes the status that should be assigned to the claim by the carrier? - correct answer INVALID
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3. Medigap coverage is offered to Medicare beneficiaries by? - correct answer PRIVATE THIRD-PARTY PAYER
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4. This provision ensures that an insured's benefits from all insurance companies does not exceed 100% of
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allowable medical - correct answer Coordination of benefits
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5. A coroner's autopsy is comprised of which examination? - correct answer Gross examination.
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6. This statement is true regarding the release of patient records? - correct answer Patient access to
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psychotherapy notes may be restricted. w w w w




7. Actions by a billing & coding specialist would be considered fraud? - correct answer Billing for services not
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provided.



8. The components of an explanation of benefits expedites the process of a phone appeal? - correct answer
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Claim control number.
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,9. On the CMS-1500 claim form, blocks 14 through 33 contain information of?. - correct answer The patient's
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condition & the provider's information w w w w




10. A billing & coding specialist should understand that the financial record source that is generated by a
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provider's office is called a? - correct answer Patient Ledger Account.
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11. The medical terms refer to the sac that endoses the heart? - correct answer Pericardium.
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12. HIPAA transaction standards apply to? - correct answer Health care clearinghouse.
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13. All dependents 10 years of age or older are required to have which of the following for TRICARE? - correct
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answer Military identification.
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14. The standard medical abbreviation "ECG" refers to a test used to assess? - correct answer Cardiovascular
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system.



15. An example of a violation of an adult patient's confidentiality? - correct answer Patient information was
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disclosed to the patient's parent without consent.
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16. Claims that are submitted without an NPI number will delay payment to the provider because? - correct
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answer the number is needed to identify the provider
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17. Sections of the medical record is used to determine the correct Evaluation & Management code used for
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billing & coding? - correct answer History & physical
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18. Actions should be taken if an insurance company denies a service as not medically necessary? - correct
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answer Appeal the decision with a provider's report.
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19. Missing #19 - correct answer misssing
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20. The function of the respiratory system? - correct answer Oxygenating blood cells
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, 21. This describes a delinquent claim? - correct answer The claim is overdue for payment.
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22. What actions should the billing & coding specialist take if he observes a colleague in an unethical
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situation? - correct answer Report the incident to a supervisor.
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23. A participating Blue Cross/Blue Shield (BC/BS) provider receives an explanation of benefits for a patient
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account. The charged amount was $100. BC/BS allowed $80 & applied $40 to the patient's annual deductible.
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BC/BS paid the balance at 80%. How much should the patient expect to pay? - correct answer $48.
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24. This statement is correct regarding a deductible? - correct answer The deductible is the patient's
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responsibility.



25. A physician ordered a comprehensive metabolic panel for a 70-year-old patient who has Medicare as her
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primary insurance. This form is required so the patient knows she may be responsible for payment? - correct
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answer Advance Beneficiary Notice.
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26. What is the purpose of precertification? - correct answer Verification of coverage.
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27. What claims is submitted & then optically scanned by the insurance carrier & converted to an electronic
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form? - correct answer Paper claim
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28. What information is required on a patient account record? - correct answer Name & address of
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guarantor.



29. This includes procedures & best practices for correct coding? - correct answer Coding Compliance Plan.
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30. A patient who has a primary malignant neoplasm of the lung should be referred to ? - correct answer
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Pulmonary oncologist w




31. ICD-9-CM codes describes the circumstances of a patient who sustained an accidental fracture of the
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proximal tibia? - correct answer E887 Fracture, cause unspecified.
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