2026 CBCS EXAMS EVALUATION QUESTIONS AND
ANSWERS SURE A+
✔✔A billing and coding specialist is processing a claim for a new patient who came to
the office for a sore throat. The provider diagnosed the patient with tonsilitis and wrote a
prescription for antibiotics. Which of the following codes should the specialist use? -
✔✔99203
✔✔A billing and coding specialist is reviewing a denied claim for a 19-year-old patient's
hysterectomy (58150-26). Which of the following is the reason for the denial? - ✔✔The
modifier is not valid with the procedure
✔✔A billing and coding specialist is preparing a small claims court case against a
patient for a delinquent account in the amount of $6,500. Which of the following is a
court order that allows payments on unsecured debt to be made directly from a
defendant's paycheck? - ✔✔Garnishment
✔✔Which of the following requires an authorization to release protected health
information (PHI)? - ✔✔Life insurance policy
✔✔Which of the following is proper supportive documentation for reporting CPT and
ICD-10-CM codes for the removal of a skin lesion? - ✔✔Operative report
✔✔A patient is preauthorized to receive vitamin B12 injections from January 1 to May
31. On June 2, the provider prescribes an additional 6 months of injections. In order for
the patient to continue with coverage of care, which of the following should occur? -
✔✔The patients third party payer should be contacted to obtain a new preauthorization
✔✔A patient was seen in an outpatient clinic for a cough, chest congestion, and a low-
grade fever and was given the diagnosis of possible pneumonia. How should a billing
and coding specialist code this encounter using ICD-10-CM? - ✔✔Cough, chest
congestion, and low-grade fever
, ✔✔A billing and coding specialist is reviewing the encounter form for a patient who has
type 1 diabetes mellitus and stage III chronic kidney (CKD). Which of the following
diagnosis codes should be assigned? - ✔✔E10.22
✔✔Which of the following is a HIPAA compliance guideline affecting health records? -
✔✔The electronic transmission and code set standards require every provider to use
the health care transactions, code sets, and identifiers
✔✔A patient presents to a provider with chest pain and shortness of breath. After an
unexpected EKG result, the provider calls a cardiologist and summarized the patient's
symptoms. Which of the following is a portion of HIPAA that allows the provider to
speak to the cardiologist prior to obtaining the patients consent? - ✔✔Title II:
Administrative Simplification
✔✔A patient Is in the third trimester of pregnancy and has developed gestational
diabetes mellitus that is diet controlled. Which of the following codes should a billing and
coding specialist assign to this patient? - ✔✔O24.410
✔✔A billing and coding specialist is processing a claim for a patient who went to the
emergency department for services. Which of the following is a component of
determining the evaluation and management (E/M) level of care? - ✔✔Medical decision
making
✔✔Which of the following does a patient sign to allow payment of claims directly to the
provider? - ✔✔Assignment of benefits statement
✔✔Which of the following actions should a billing and coding specialist take when
submitting a claim to Medicaid for a patient who has primary and secondary insurance
coverage? - ✔✔Attach the remittance advice from the primary insurance along with the
Medicaid claim
✔✔Which of the following describes an insurance company that offers plans that pay
health care providers who render services to patients? - ✔✔Third-party payer
✔✔A billing and coding specialist is reviewing an operative report for a patient who had
a graft. The specialist should consult the CPT coding guidelines to determine that which
of the following is a tissue transplanted from one individual to another of the same
species but different genotype? - ✔✔Allograft
✔✔A billing and coding specialist is posting payments to accounts based on a
remittance advice and discovers a denial of payment. Which of the following codes
indicates why reimbursement was denied? - ✔✔Claims adjustment reason code
ANSWERS SURE A+
✔✔A billing and coding specialist is processing a claim for a new patient who came to
the office for a sore throat. The provider diagnosed the patient with tonsilitis and wrote a
prescription for antibiotics. Which of the following codes should the specialist use? -
✔✔99203
✔✔A billing and coding specialist is reviewing a denied claim for a 19-year-old patient's
hysterectomy (58150-26). Which of the following is the reason for the denial? - ✔✔The
modifier is not valid with the procedure
✔✔A billing and coding specialist is preparing a small claims court case against a
patient for a delinquent account in the amount of $6,500. Which of the following is a
court order that allows payments on unsecured debt to be made directly from a
defendant's paycheck? - ✔✔Garnishment
✔✔Which of the following requires an authorization to release protected health
information (PHI)? - ✔✔Life insurance policy
✔✔Which of the following is proper supportive documentation for reporting CPT and
ICD-10-CM codes for the removal of a skin lesion? - ✔✔Operative report
✔✔A patient is preauthorized to receive vitamin B12 injections from January 1 to May
31. On June 2, the provider prescribes an additional 6 months of injections. In order for
the patient to continue with coverage of care, which of the following should occur? -
✔✔The patients third party payer should be contacted to obtain a new preauthorization
✔✔A patient was seen in an outpatient clinic for a cough, chest congestion, and a low-
grade fever and was given the diagnosis of possible pneumonia. How should a billing
and coding specialist code this encounter using ICD-10-CM? - ✔✔Cough, chest
congestion, and low-grade fever
, ✔✔A billing and coding specialist is reviewing the encounter form for a patient who has
type 1 diabetes mellitus and stage III chronic kidney (CKD). Which of the following
diagnosis codes should be assigned? - ✔✔E10.22
✔✔Which of the following is a HIPAA compliance guideline affecting health records? -
✔✔The electronic transmission and code set standards require every provider to use
the health care transactions, code sets, and identifiers
✔✔A patient presents to a provider with chest pain and shortness of breath. After an
unexpected EKG result, the provider calls a cardiologist and summarized the patient's
symptoms. Which of the following is a portion of HIPAA that allows the provider to
speak to the cardiologist prior to obtaining the patients consent? - ✔✔Title II:
Administrative Simplification
✔✔A patient Is in the third trimester of pregnancy and has developed gestational
diabetes mellitus that is diet controlled. Which of the following codes should a billing and
coding specialist assign to this patient? - ✔✔O24.410
✔✔A billing and coding specialist is processing a claim for a patient who went to the
emergency department for services. Which of the following is a component of
determining the evaluation and management (E/M) level of care? - ✔✔Medical decision
making
✔✔Which of the following does a patient sign to allow payment of claims directly to the
provider? - ✔✔Assignment of benefits statement
✔✔Which of the following actions should a billing and coding specialist take when
submitting a claim to Medicaid for a patient who has primary and secondary insurance
coverage? - ✔✔Attach the remittance advice from the primary insurance along with the
Medicaid claim
✔✔Which of the following describes an insurance company that offers plans that pay
health care providers who render services to patients? - ✔✔Third-party payer
✔✔A billing and coding specialist is reviewing an operative report for a patient who had
a graft. The specialist should consult the CPT coding guidelines to determine that which
of the following is a tissue transplanted from one individual to another of the same
species but different genotype? - ✔✔Allograft
✔✔A billing and coding specialist is posting payments to accounts based on a
remittance advice and discovers a denial of payment. Which of the following codes
indicates why reimbursement was denied? - ✔✔Claims adjustment reason code
