NHA CBCS EXAM 3 Questions and Answers with
Rationales 2026/2027 Update
1. Which code set is primarily used to report diagnoses in outpatient
professional healthcare settings?
A. CPT
B. ICD-10-CM
C. ICD-10-PCS
D. CDT
Answer: B
Rationale: ICD-10-CM is the U.S. diagnosis classification system used to
report diseases, conditions, symptoms, and reasons for encounters.
2. Which code set is primarily used to report physician procedures and
services?
A. CPT
B. ICD-10-CM
C. ICD-10-PCS
D. DRG
Answer: A
Rationale: CPT describes professional medical, surgical, and diagnostic
services.
3. HCPCS Level II codes are commonly used for:
A. Diagnoses
B. Supplies, equipment, and certain drugs and services
C. Inpatient procedures only
D. Physician credentials
,Answer: B
Rationale: HCPCS Level II supplements CPT for items and services such
as durable medical equipment, ambulance services, and certain
medications.
4. ICD-10-PCS is primarily used for:
A. Physician office procedures
B. Inpatient hospital procedures
C. Dental procedures
D. Outpatient diagnoses
Answer: B
Rationale: ICD-10-PCS is used to report procedures performed on
hospital inpatients.
5. Who maintains the CPT code set?
A. CDC
B. AMA
C. CMS
D. OSHA
Answer: B
Rationale: The American Medical Association maintains CPT.
6. Which organization administers Medicare?
A. CMS
B. AMA
C. FDA
D. AHA
Answer: A
Rationale: The Centers for Medicare & Medicaid Services administers
Medicare.
,7. What is the purpose of the ICD-10-CM Alphabetic Index?
A. To provide the initial location of diagnosis codes
B. To determine reimbursement
C. To identify CPT modifiers
D. To calculate patient responsibility
Answer: A
Rationale: Coders generally begin with the Alphabetic Index and then
verify the code in the Tabular List.
8. Why must the Tabular List be reviewed after locating a code in the
Index?
A. To verify instructions and required specificity
B. To determine the patient's insurance
C. To calculate the deductible
D. To identify the provider's NPI
Answer: A
Rationale: The Tabular List contains essential coding instructions,
inclusion terms, exclusions, and specificity requirements.
9. What does laterality indicate?
A. Severity
B. Body side
C. Insurance type
D. Treatment duration
Answer: B
Rationale: Laterality identifies whether the condition affects the right,
left, or both sides when applicable.
10. A diagnosis code requires laterality, and documentation states
"right." Which code should be selected?
A. Unspecified
, B. Left
C. Right
D. Bilateral
Answer: C
Rationale: Coding should use the highest level of specificity supported
by documentation.
11. An Excludes1 note generally means:
A. The two conditions should not be coded together
B. The second code is mandatory
C. The code is optional
D. The code is obsolete
Answer: A
Rationale: Excludes1 generally indicates that the excluded condition
should not be reported with the code.
12. An Excludes2 note means:
A. The excluded condition may be coded separately when appropriate
B. The condition can never be reported
C. The code is invalid
D. The code must be sequenced first
Answer: A
Rationale: Excludes2 means the condition is not included in the code
but may coexist and be separately reported.
13. What does a "code first" instruction tell the coder?
A. Sequence the underlying condition before the current code
B. Always use the code first on every claim
C. Delete the code
D. Use a CPT modifier
Rationales 2026/2027 Update
1. Which code set is primarily used to report diagnoses in outpatient
professional healthcare settings?
A. CPT
B. ICD-10-CM
C. ICD-10-PCS
D. CDT
Answer: B
Rationale: ICD-10-CM is the U.S. diagnosis classification system used to
report diseases, conditions, symptoms, and reasons for encounters.
2. Which code set is primarily used to report physician procedures and
services?
A. CPT
B. ICD-10-CM
C. ICD-10-PCS
D. DRG
Answer: A
Rationale: CPT describes professional medical, surgical, and diagnostic
services.
3. HCPCS Level II codes are commonly used for:
A. Diagnoses
B. Supplies, equipment, and certain drugs and services
C. Inpatient procedures only
D. Physician credentials
,Answer: B
Rationale: HCPCS Level II supplements CPT for items and services such
as durable medical equipment, ambulance services, and certain
medications.
4. ICD-10-PCS is primarily used for:
A. Physician office procedures
B. Inpatient hospital procedures
C. Dental procedures
D. Outpatient diagnoses
Answer: B
Rationale: ICD-10-PCS is used to report procedures performed on
hospital inpatients.
5. Who maintains the CPT code set?
A. CDC
B. AMA
C. CMS
D. OSHA
Answer: B
Rationale: The American Medical Association maintains CPT.
6. Which organization administers Medicare?
A. CMS
B. AMA
C. FDA
D. AHA
Answer: A
Rationale: The Centers for Medicare & Medicaid Services administers
Medicare.
,7. What is the purpose of the ICD-10-CM Alphabetic Index?
A. To provide the initial location of diagnosis codes
B. To determine reimbursement
C. To identify CPT modifiers
D. To calculate patient responsibility
Answer: A
Rationale: Coders generally begin with the Alphabetic Index and then
verify the code in the Tabular List.
8. Why must the Tabular List be reviewed after locating a code in the
Index?
A. To verify instructions and required specificity
B. To determine the patient's insurance
C. To calculate the deductible
D. To identify the provider's NPI
Answer: A
Rationale: The Tabular List contains essential coding instructions,
inclusion terms, exclusions, and specificity requirements.
9. What does laterality indicate?
A. Severity
B. Body side
C. Insurance type
D. Treatment duration
Answer: B
Rationale: Laterality identifies whether the condition affects the right,
left, or both sides when applicable.
10. A diagnosis code requires laterality, and documentation states
"right." Which code should be selected?
A. Unspecified
, B. Left
C. Right
D. Bilateral
Answer: C
Rationale: Coding should use the highest level of specificity supported
by documentation.
11. An Excludes1 note generally means:
A. The two conditions should not be coded together
B. The second code is mandatory
C. The code is optional
D. The code is obsolete
Answer: A
Rationale: Excludes1 generally indicates that the excluded condition
should not be reported with the code.
12. An Excludes2 note means:
A. The excluded condition may be coded separately when appropriate
B. The condition can never be reported
C. The code is invalid
D. The code must be sequenced first
Answer: A
Rationale: Excludes2 means the condition is not included in the code
but may coexist and be separately reported.
13. What does a "code first" instruction tell the coder?
A. Sequence the underlying condition before the current code
B. Always use the code first on every claim
C. Delete the code
D. Use a CPT modifier