Questions + Rationales, Pass Confidently
If the insurance and coding specialist suspects Medicare
fraud, she should contact the
A. DOJ.
B. AMA.
C. FDA.
D. OIG. - Correct Answers ✅D. OIG
Collecting statistics on the frequency of copay collection at
time of service is a step in the process of
A. a recovery audit.
B. managing A/R.
C. claims management.
D. performance reviews. - Correct Answers ✅B. managing
A/R
When the patient has signed the assignment of benefits form,
the payment for services should be sent to the provider
unless the provider is
A. in-network.
B. out of network.
C. the primary care provider.
D. a referred specialist. - Correct Answers ✅B. out of
network.
,NCCT PRACTICE 2026 Updated Practice
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When speaking with an insurance company representative to
follow up on a denied claim, an insurance and coding
specialist should have which of the following information
available? (Select the three (3) Correct Answers ).
A. date of service
B. physician's NPI
C. patient's mailing address
D. patient's insurance ID number
E. date the claim was denied - Correct Answers ✅A. date of
service
D. patient's insurance ID number
E. date the claim was denied
Which of the following defines the maximum time that a debt
can be collected from the time it was incurred or became
due?
A. benchmark
B. practice management payment policy
C. statute of limitations
D. Stark Law - Correct Answers ✅C. statute of limitations
A physician performed a bilateral L4/L5 Laminectomy on a
patient in an ambulatory surgical center. Which of the
,NCCT PRACTICE 2026 Updated Practice
Questions + Rationales, Pass Confidently
following place of service codes should be used on the CMS
1500?
A. 24
B. 22
C. 21
D. 11 - Correct Answers ✅A. 24
An insurance and coding specialist is reviewing a patient's
encounter form that is documented in the medical record
prior to completing a CMS-1500 form. She notices that the
physician upcoded the encounter form. The specialist has the
ethical obligation to first
A. query the physician.
B. correct the code.
C. down code.
D. report the physician to the state board. - Correct
Answers ✅A. query the physician.
In situations in which the provider is paid the same rate per
patient whether or not they provide services and no matter
which services were provided, the payment is known as:
A. coinsurance.
B. capitation.
C. fee for service.
, NCCT PRACTICE 2026 Updated Practice
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D. a deductible. - Correct Answers ✅B. capitation.
When posting transactions for electronic claims submission, it
is necessary to enter which of the following items onto the
claim?
A. physician's office fee
B. physician's contractual fee
C. insurance plan's allowable fee
D. insurance plan's UCR fee - Correct Answers ✅A.
physician's office fee
Which of the following is the most likely cause of the deposits
not agreeing with the credits on the day sheet or the patient
ledgers?
A. Payment is misplaced.
B. The bank made an error.
C. Cash is missing.
D. There are duplicate cards. - Correct Answers ✅A.
Payment is misplaced.
A patient is seen in the office for a candidal paronychia nail
abscess which was incised and drained. Which of the
following is the correct CPT® code assignment for physician
services only?
A. 10080