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NHA CBCS Practice Exam 2 | Certified Billing and Coding Specialist Exam Review with Answers and Rationales

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This second CBCS practice exam includes 100 updated questions reflecting real exam standards. It reviews ICD-10-CM, CPT, and HCPCS coding, claim submission via CMS-1500, Medicare and commercial insurance rules, HIPAA compliance, and medical terminology. Designed for practical exam preparation, it reinforces billing accuracy, regulatory compliance, and ethical practices in healthcare reimbursement.

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NHA CBCS PRACTICE EXAM
Actual Questions with Verified Answers & Rationales
100% Guarantee passing score of 390 or higher


Consist of 100 multichoice Questions with Answers

1. A 45-year-old patient named John presents with chest pain and shortness
of breath.The physician documents a diagnosis of acute myocardial infarction
(AMI) and orders a series of tests and treatments. When abstracting the re-
quired health information from the clinical documentation, which code should
be assigned for the diagnosis of AMI?


A) I21.9
B) I20.0
C) I25.10
D) I50.9
Answer
I21.9


2. Dr. Smith performed a bilateral procedure on Jane Doe, which was initially
billed as two separate procedures. To correct the claim and ensure proper
reimbursement, which modifier should be used?

,A) Modifier -50


B) Modifier -51


C) Modifier -59


D) Modifier -25
Answer
Modifier -50



3. What is the primary purpose of a deductible in a health insurance policy?


A) To limit the total out-of-pocket expenses for the insured


B) To cover the cost of preventative care services


C) To share the cost of healthcare between the insured and the insurer


D) To eliminate the need for co-payments
Answer
To share the cost of healthcare between the insured and the insurer



4. Dr. Smith conducted a comprehensive history and examination for a new
patient, John Doe, who presented with multiple chronic conditions requiring

, moderate complexity medical decision-making. The total face-to-face time
spent was 45 minutes. Which E/M code is most appropriate for this encounter?


A) 99203


B) 99204


C) 99205


E) 99212
Answer
99204


5. Emily, an uninsured patient, visits a healthcare facility for a routine
check-up. According to the facility's policies and procedures regarding unin-
sured or self-pay patients, which is the first step the billing department should
take?


A) Offer a payment plan immediately


B) Verify if the patient qualifies for any financial assistance programs


C) Provide an estimate of the total cost of services


D) Request full payment upfront before any services are rendered
Answer

, Verify if the patient qualifies for any financial assistance programs
6. Sarah, a medical coder, is reviewing the latest updates to the ICD-10-CM
coding guidelines. She needs to ensure that her coding practices align with
the most current standards. Which organization is responsible for publishing
and updating the ICD-10-CM coding guidelines.


A) American Medical Association (AMA)


B) National Center for Health Statistics (NCHS)


C) Centers for Medicare & Medicaid Services (CMS)


D) World Health Organization (WHO)
Answer
National Center for Health Statistics (NCHS)



7. Sarah, a medical billing specialist, notices that a claim for a patient named
John Doe was rejected due to an "invalid diagnosis code". Which of the
following actions should Sarah take to resolve this issue?

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