NHA CBCS Practice Test #5 Exam Guide 2025-
2026
1. Which of the following requires an authorization to Life insurnace policy
release protected health information (PHI)?
2. A billing and coding specialist is preparing a claim for 99213
an outpatient encounter. The patient was last seen in
the office two years ago. Which of the following eval-
uation and management codes should the specialist
use?
3. A billing and coding specialist is coding a claim for an 88000
autopsy. Which of the following CPT codes should be
included in the claim?
4. A provider orders a comprehensive metabolic panel Advance Beneficiary No-
for a 70 year old patient who has Medicare as their tice
primary insurance. Which of the following is required
to inform the patient they may be responsible for
payment?
5. A billing and coding specialist is coding a consultation 99243
in the providers office. The provider documented the
appropriate history and exam, with low level medical
decision making. Which of the following evaluation
and management (E/M) codes should the specialist
report?
6. A billing and coding specialist is reviewing a claim Date of birth
edit report and identifies a rejection for missing pa-
tient demographic information would cause a rejec-
tion from the clearinghouse?
7. Precertification
, NHA CBCS Practice Test #5 Exam Guide 2025-
2026
Which of the following processes is used to verify pa-
tient benefits and insurance coverage for an outpa-
tient procedure?
8. A married couple each have group insurance through The patient's policy
there employers. The patient has an appointment
with the provider. Which insurance should be used as
primary for the appointment?
9. A billing and coding specialist is training a new special- Checking claims against
ist about submitting claims to a clearinghouse. payer edits for missing,
Which of the following describes the process complet- incomplete, or invalid in-
ed by the clearinghouse before submitting claims to a formation
third-party payer?
10. A billing and coding specialist is collecting demo- TRICARE
graphic information for a patient who lives in Hawaii
and is an active duty service member. The specialist
should identify that the insured has which of the fol-
lowing types of insurance?
11. Which of the folllowing is a valid type of authorization Subpoena duces tecum
used to release medical information to the judicial
system?
12. A billing and coding specialist is posting payments for Charged amount-pay-
an explanation of benefits (EOB). Which of the follow- ment amount- adjusted
ing equations determines how patient responsibility amount= patient respon-
is calculated? sibility
13. A billing and coding specialist is processing a claim for Crossover
a patient who has Medicare and Medicaid coverage.
Which of the following is the type of claim that is
2026
1. Which of the following requires an authorization to Life insurnace policy
release protected health information (PHI)?
2. A billing and coding specialist is preparing a claim for 99213
an outpatient encounter. The patient was last seen in
the office two years ago. Which of the following eval-
uation and management codes should the specialist
use?
3. A billing and coding specialist is coding a claim for an 88000
autopsy. Which of the following CPT codes should be
included in the claim?
4. A provider orders a comprehensive metabolic panel Advance Beneficiary No-
for a 70 year old patient who has Medicare as their tice
primary insurance. Which of the following is required
to inform the patient they may be responsible for
payment?
5. A billing and coding specialist is coding a consultation 99243
in the providers office. The provider documented the
appropriate history and exam, with low level medical
decision making. Which of the following evaluation
and management (E/M) codes should the specialist
report?
6. A billing and coding specialist is reviewing a claim Date of birth
edit report and identifies a rejection for missing pa-
tient demographic information would cause a rejec-
tion from the clearinghouse?
7. Precertification
, NHA CBCS Practice Test #5 Exam Guide 2025-
2026
Which of the following processes is used to verify pa-
tient benefits and insurance coverage for an outpa-
tient procedure?
8. A married couple each have group insurance through The patient's policy
there employers. The patient has an appointment
with the provider. Which insurance should be used as
primary for the appointment?
9. A billing and coding specialist is training a new special- Checking claims against
ist about submitting claims to a clearinghouse. payer edits for missing,
Which of the following describes the process complet- incomplete, or invalid in-
ed by the clearinghouse before submitting claims to a formation
third-party payer?
10. A billing and coding specialist is collecting demo- TRICARE
graphic information for a patient who lives in Hawaii
and is an active duty service member. The specialist
should identify that the insured has which of the fol-
lowing types of insurance?
11. Which of the folllowing is a valid type of authorization Subpoena duces tecum
used to release medical information to the judicial
system?
12. A billing and coding specialist is posting payments for Charged amount-pay-
an explanation of benefits (EOB). Which of the follow- ment amount- adjusted
ing equations determines how patient responsibility amount= patient respon-
is calculated? sibility
13. A billing and coding specialist is processing a claim for Crossover
a patient who has Medicare and Medicaid coverage.
Which of the following is the type of claim that is
