NHA CBCS Exam Questions & Answers
(2024/2025) | 100% Verified |
Guaranteed Pass
Question 1: Which of the following is the primary purpose of the CPT code set? A. To report
medical diagnoses B. To report medical procedures and services C. To classify patient
demographics D. To track hospital admissions
Correct Answer: B Rationale: The CPT (Current Procedural Terminology) code set is used
to report medical procedures and services performed by healthcare providers. ICD-10-CM
(A) is used for diagnoses. Classifying patient demographics (C) and tracking hospital
admissions (D) are not functions of CPT.
Question 2: What is the correct format for an ICD-10-CM diagnosis code? A. Three digits B.
Three to seven alphanumeric characters C. Five digits D. Alphanumeric with a decimal point
Correct Answer: B Rationale: ICD-10-CM codes are 3 to 7 alphanumeric characters (e.g.,
S06.0X1A). Three digits (A) is too short, five digits (C) is insufficient, and a decimal point (D) is
not used in ICD-10-CM.
Question 3: Which HCPCS Level II code is used for ambulance services? A. A0000–A0999 B.
E0000–E9999 C. J0000–J9999 D. S0000–S9999
Correct Answer: A Rationale: HCPCS Level II codes A0000–A0999 are used for ambulance
services. E-codes (B) are for durable medical equipment, J-codes (C) are for drugs, and
S-codes (D) are state-specific codes.
Question 4: What is the purpose of a modifier in CPT coding? A. To replace the primary code B.
To provide additional information about a procedure or service C. To indicate the patient’s
insurance type D. To classify the provider’s specialty
,Correct Answer: B Rationale: A modifier in CPT coding provides additional information
about a procedure or service (e.g., -25 for a significant, separately identifiable E/M service).
Modifiers do not replace codes (A), indicate insurance (C), or classify provider specialty (D).
Question 5: Which of the following is an example of a Category II CPT code? A. 99213 B. 0001F
C. J1234 D. G0101
Correct Answer: B Rationale: Category II CPT codes are alphanumeric and end with an
"F" (e.g., 0001F). 99213 (A) is a Category I code, J1234 (C) is a HCPCS Level II code, and
G0101 (D) is a HCPCS Level II code for Medicare.
Question 6: What is the correct sequence for the medical billing process? A. Patient registration
→ Charge entry → Claim submission → Payment posting B. Claim submission → Patient
registration → Charge entry → Payment posting C. Payment posting → Patient registration →
Charge entry → Claim submission D. Charge entry → Patient registration → Claim submission
→ Payment posting
Correct Answer: A Rationale: The correct sequence is:
1. Patient registration
2. Charge entry (coding and entering charges)
3. Claim submission (sending the claim to the payer)
4. Payment posting (recording payments and adjustments). The other options (B, C, D)
are out of order.
Question 7: Which of the following is a required element for a valid CMS-1500 claim form? A.
Patient’s credit card number B. Provider’s NPI number C. Patient’s employment history D.
Patient’s marital status
Correct Answer: B Rationale: The provider’s NPI (National Provider Identifier) is a
required element on the CMS-1500 claim form. Credit card number (A), employment history
(C), and marital status (D) are not required.
Question 8: What is the purpose of the Advance Beneficiary Notice of Noncoverage (ABN)? A.
To inform Medicare patients that a service may not be covered B. To request payment from the
patient before services are rendered C. To notify the provider of a claim denial D. To appeal a
denied claim
,Correct Answer: A Rationale: The ABN is used to inform Medicare patients that a service
may not be covered and that they may be financially responsible. It is not a request for payment
(B), a denial notification (C), or an appeal (D).
Question 9: Which of the following is an example of a clean claim? A. A claim with missing
patient information B. A claim with incorrect coding C. A claim submitted with all required
information and no errors D. A claim submitted after the timely filing limit
Correct Answer: C Rationale: A clean claim is one that is complete, accurate, and
submitted with all required information. Missing information (A), incorrect coding (B), and late
submission (D) are not clean claims.
Question 10: What is the primary purpose of the HIPAA Privacy Rule? A. To ensure healthcare
providers are paid promptly B. To protect the privacy of individually identifiable health information
C. To standardize medical billing codes D. To reduce healthcare costs
Correct Answer: B Rationale: The HIPAA Privacy Rule is designed to protect the privacy of
individually identifiable health information. Payment promptness (A), billing codes (C), and
cost reduction (D) are not the primary purposes of the Privacy Rule.
Question 11: Which of the following is a HIPAA Security Rule requirement? A. Providing patients
with a copy of their medical records upon request B. Implementing administrative, physical, and
technical safeguards to protect electronic health information C. Ensuring all claims are
submitted electronically D. Requiring patients to sign a consent form before treatment
Correct Answer: B Rationale: The HIPAA Security Rule requires administrative, physical,
and technical safeguards to protect electronic health information. Providing medical
records (A) is a Privacy Rule requirement. Electronic claims submission (C) is unrelated.
Consent forms (D) are not a Security Rule requirement.
Question 12: What is the purpose of the HIPAA Breach Notification Rule? A. To notify patients of
changes in their insurance coverage B. To require covered entities to notify affected individuals of
a breach of unsecured protected health information C. To inform healthcare providers of new
coding guidelines D. To report all medical errors to a central database
Correct Answer: B Rationale: The HIPAA Breach Notification Rule requires covered
entities to notify affected individuals when there is a breach of unsecured protected
, health information. Insurance changes (A), coding guidelines (C), and error reporting (D) are
unrelated.
Question 13: Which of the following is a required element of a patient’s medical record under
HIPAA? A. Patient’s credit score B. Date and time of each visit C. Patient’s employment history
D. Patient’s political affiliation
Correct Answer: B Rationale: The date and time of each visit is a required element of a
patient’s medical record. Credit score (A), employment history (C), and political affiliation (D) are
not required.
Question 14: What is the primary purpose of an audit trail in an electronic health record (EHR)?
A. To track changes made to patient records B. To store patient demographic information C. To
generate billing statements D. To schedule patient appointments
Correct Answer: A Rationale: An audit trail in an EHR tracks changes made to patient
records, including who made the change and when. Storing demographics (B), generating bills
(C), and scheduling appointments (D) are not the primary purposes of an audit trail.
Question 15: Which of the following is an example of protected health information (PHI) under
HIPAA? A. Patient’s favorite color B. Patient’s medical record number C. Patient’s shoe size D.
Patient’s hobbies
Correct Answer: B Rationale: A patient’s medical record number is protected health
information (PHI) under HIPAA. Favorite color (A), shoe size (C), and hobbies (D) are not
considered PHI.
Question 16: What is the purpose of the National Correct Coding Initiative (NCCI) edits? A. To
ensure claims are submitted electronically B. To prevent improper payment for services that
should not be billed together C. To standardize patient demographic information D. To reduce the
number of medical codes
Correct Answer: B Rationale: NCCI edits are designed to prevent improper payment for
services that should not be billed together (e.g., mutually exclusive procedures). Electronic
submission (A), demographic standardization (C), and reducing codes (D) are unrelated.
(2024/2025) | 100% Verified |
Guaranteed Pass
Question 1: Which of the following is the primary purpose of the CPT code set? A. To report
medical diagnoses B. To report medical procedures and services C. To classify patient
demographics D. To track hospital admissions
Correct Answer: B Rationale: The CPT (Current Procedural Terminology) code set is used
to report medical procedures and services performed by healthcare providers. ICD-10-CM
(A) is used for diagnoses. Classifying patient demographics (C) and tracking hospital
admissions (D) are not functions of CPT.
Question 2: What is the correct format for an ICD-10-CM diagnosis code? A. Three digits B.
Three to seven alphanumeric characters C. Five digits D. Alphanumeric with a decimal point
Correct Answer: B Rationale: ICD-10-CM codes are 3 to 7 alphanumeric characters (e.g.,
S06.0X1A). Three digits (A) is too short, five digits (C) is insufficient, and a decimal point (D) is
not used in ICD-10-CM.
Question 3: Which HCPCS Level II code is used for ambulance services? A. A0000–A0999 B.
E0000–E9999 C. J0000–J9999 D. S0000–S9999
Correct Answer: A Rationale: HCPCS Level II codes A0000–A0999 are used for ambulance
services. E-codes (B) are for durable medical equipment, J-codes (C) are for drugs, and
S-codes (D) are state-specific codes.
Question 4: What is the purpose of a modifier in CPT coding? A. To replace the primary code B.
To provide additional information about a procedure or service C. To indicate the patient’s
insurance type D. To classify the provider’s specialty
,Correct Answer: B Rationale: A modifier in CPT coding provides additional information
about a procedure or service (e.g., -25 for a significant, separately identifiable E/M service).
Modifiers do not replace codes (A), indicate insurance (C), or classify provider specialty (D).
Question 5: Which of the following is an example of a Category II CPT code? A. 99213 B. 0001F
C. J1234 D. G0101
Correct Answer: B Rationale: Category II CPT codes are alphanumeric and end with an
"F" (e.g., 0001F). 99213 (A) is a Category I code, J1234 (C) is a HCPCS Level II code, and
G0101 (D) is a HCPCS Level II code for Medicare.
Question 6: What is the correct sequence for the medical billing process? A. Patient registration
→ Charge entry → Claim submission → Payment posting B. Claim submission → Patient
registration → Charge entry → Payment posting C. Payment posting → Patient registration →
Charge entry → Claim submission D. Charge entry → Patient registration → Claim submission
→ Payment posting
Correct Answer: A Rationale: The correct sequence is:
1. Patient registration
2. Charge entry (coding and entering charges)
3. Claim submission (sending the claim to the payer)
4. Payment posting (recording payments and adjustments). The other options (B, C, D)
are out of order.
Question 7: Which of the following is a required element for a valid CMS-1500 claim form? A.
Patient’s credit card number B. Provider’s NPI number C. Patient’s employment history D.
Patient’s marital status
Correct Answer: B Rationale: The provider’s NPI (National Provider Identifier) is a
required element on the CMS-1500 claim form. Credit card number (A), employment history
(C), and marital status (D) are not required.
Question 8: What is the purpose of the Advance Beneficiary Notice of Noncoverage (ABN)? A.
To inform Medicare patients that a service may not be covered B. To request payment from the
patient before services are rendered C. To notify the provider of a claim denial D. To appeal a
denied claim
,Correct Answer: A Rationale: The ABN is used to inform Medicare patients that a service
may not be covered and that they may be financially responsible. It is not a request for payment
(B), a denial notification (C), or an appeal (D).
Question 9: Which of the following is an example of a clean claim? A. A claim with missing
patient information B. A claim with incorrect coding C. A claim submitted with all required
information and no errors D. A claim submitted after the timely filing limit
Correct Answer: C Rationale: A clean claim is one that is complete, accurate, and
submitted with all required information. Missing information (A), incorrect coding (B), and late
submission (D) are not clean claims.
Question 10: What is the primary purpose of the HIPAA Privacy Rule? A. To ensure healthcare
providers are paid promptly B. To protect the privacy of individually identifiable health information
C. To standardize medical billing codes D. To reduce healthcare costs
Correct Answer: B Rationale: The HIPAA Privacy Rule is designed to protect the privacy of
individually identifiable health information. Payment promptness (A), billing codes (C), and
cost reduction (D) are not the primary purposes of the Privacy Rule.
Question 11: Which of the following is a HIPAA Security Rule requirement? A. Providing patients
with a copy of their medical records upon request B. Implementing administrative, physical, and
technical safeguards to protect electronic health information C. Ensuring all claims are
submitted electronically D. Requiring patients to sign a consent form before treatment
Correct Answer: B Rationale: The HIPAA Security Rule requires administrative, physical,
and technical safeguards to protect electronic health information. Providing medical
records (A) is a Privacy Rule requirement. Electronic claims submission (C) is unrelated.
Consent forms (D) are not a Security Rule requirement.
Question 12: What is the purpose of the HIPAA Breach Notification Rule? A. To notify patients of
changes in their insurance coverage B. To require covered entities to notify affected individuals of
a breach of unsecured protected health information C. To inform healthcare providers of new
coding guidelines D. To report all medical errors to a central database
Correct Answer: B Rationale: The HIPAA Breach Notification Rule requires covered
entities to notify affected individuals when there is a breach of unsecured protected
, health information. Insurance changes (A), coding guidelines (C), and error reporting (D) are
unrelated.
Question 13: Which of the following is a required element of a patient’s medical record under
HIPAA? A. Patient’s credit score B. Date and time of each visit C. Patient’s employment history
D. Patient’s political affiliation
Correct Answer: B Rationale: The date and time of each visit is a required element of a
patient’s medical record. Credit score (A), employment history (C), and political affiliation (D) are
not required.
Question 14: What is the primary purpose of an audit trail in an electronic health record (EHR)?
A. To track changes made to patient records B. To store patient demographic information C. To
generate billing statements D. To schedule patient appointments
Correct Answer: A Rationale: An audit trail in an EHR tracks changes made to patient
records, including who made the change and when. Storing demographics (B), generating bills
(C), and scheduling appointments (D) are not the primary purposes of an audit trail.
Question 15: Which of the following is an example of protected health information (PHI) under
HIPAA? A. Patient’s favorite color B. Patient’s medical record number C. Patient’s shoe size D.
Patient’s hobbies
Correct Answer: B Rationale: A patient’s medical record number is protected health
information (PHI) under HIPAA. Favorite color (A), shoe size (C), and hobbies (D) are not
considered PHI.
Question 16: What is the purpose of the National Correct Coding Initiative (NCCI) edits? A. To
ensure claims are submitted electronically B. To prevent improper payment for services that
should not be billed together C. To standardize patient demographic information D. To reduce the
number of medical codes
Correct Answer: B Rationale: NCCI edits are designed to prevent improper payment for
services that should not be billed together (e.g., mutually exclusive procedures). Electronic
submission (A), demographic standardization (C), and reducing codes (D) are unrelated.
