NHA CBCS EXAM 2 Questions and Answers with
Rationales 2026/2027 Update
1. What is the primary purpose of medical billing?
A. To diagnose patients
B. To submit accurate claims for reimbursement of documented
services
C. To determine treatment plans
D. To prescribe medications
Answer: B
Rationale: Medical billing converts documented healthcare services
into claims submitted to the appropriate payer for reimbursement.
2. Which code set is used primarily to report diagnoses in U.S.
healthcare?
A. CPT
B. HCPCS Level II
C. ICD-10-CM
D. CDT
Answer: C
Rationale: ICD-10-CM is the U.S. diagnosis classification system.
3. Which code set describes physician and other professional
procedures and services?
A. CPT
B. ICD-10-CM
C. ICD-10-PCS
D. NDC
,Answer: A
Rationale: CPT describes medical, surgical, and diagnostic professional
services and procedures.
4. ICD-10-PCS is primarily used for:
A. Physician office diagnoses
B. Inpatient hospital procedures
C. Dental procedures
D. Prescription drugs
Answer: B
Rationale: ICD-10-PCS is the procedure classification system used for
inpatient hospital procedures.
5. HCPCS Level II codes commonly describe:
A. Diagnoses only
B. Supplies, equipment, drugs, and certain services
C. Inpatient diagnoses
D. Dental procedures exclusively
Answer: B
Rationale: HCPCS Level II supplements CPT by reporting items and
services such as durable medical equipment, supplies, and certain
medications.
6. Which organization maintains CPT?
A. CDC
B. AMA
C. CMS
D. OSHA
Answer: B
Rationale: The American Medical Association maintains CPT.
,7. Which organization administers Medicare?
A. CMS
B. AMA
C. FDA
D. OSHA
Answer: A
Rationale: The Centers for Medicare & Medicaid Services administers
Medicare and oversees Medicaid in partnership with states.
8. What is the first place a coder generally looks when searching for an
ICD-10-CM diagnosis term?
A. Tabular List
B. Alphabetic Index
C. CPT Index
D. HCPCS Table
Answer: B
Rationale: The Alphabetic Index provides the initial location for finding
a diagnosis term.
9. Why must the Tabular List be consulted after using the Alphabetic
Index?
A. To verify the code and review instructions
B. To determine insurance eligibility
C. To calculate coinsurance
D. To identify the patient's provider
Answer: A
Rationale: The Tabular List contains code-specific instructions, inclusion
terms, exclusions, and required specificity.
10. What does an Excludes1 note generally indicate?
A. The conditions should not ordinarily be coded together
, B. The second condition must be coded
C. The code is optional
D. The code is for outpatient use only
Answer: A
Rationale: Excludes1 generally means the excluded condition is not
coded with the code where the note appears.
11. An Excludes2 note indicates that:
A. The excluded condition may be coded separately when appropriate
B. The condition can never be coded
C. The code must be deleted
D. The condition is always principal
Answer: A
Rationale: Excludes2 means the excluded condition is not included in
the code but may coexist and be separately reported.
12. A combination code is used when:
A. One code represents multiple related diagnostic elements
B. A payer rejects a claim
C. A patient has two insurance plans
D. A procedure is performed twice
Answer: A
Rationale: Combination codes capture multiple related elements, such
as a disease with a complication, in a single code when applicable.
13. What does laterality identify?
A. The severity of a condition
B. The side of the body affected
C. The provider's specialty
D. The patient's insurance
Rationales 2026/2027 Update
1. What is the primary purpose of medical billing?
A. To diagnose patients
B. To submit accurate claims for reimbursement of documented
services
C. To determine treatment plans
D. To prescribe medications
Answer: B
Rationale: Medical billing converts documented healthcare services
into claims submitted to the appropriate payer for reimbursement.
2. Which code set is used primarily to report diagnoses in U.S.
healthcare?
A. CPT
B. HCPCS Level II
C. ICD-10-CM
D. CDT
Answer: C
Rationale: ICD-10-CM is the U.S. diagnosis classification system.
3. Which code set describes physician and other professional
procedures and services?
A. CPT
B. ICD-10-CM
C. ICD-10-PCS
D. NDC
,Answer: A
Rationale: CPT describes medical, surgical, and diagnostic professional
services and procedures.
4. ICD-10-PCS is primarily used for:
A. Physician office diagnoses
B. Inpatient hospital procedures
C. Dental procedures
D. Prescription drugs
Answer: B
Rationale: ICD-10-PCS is the procedure classification system used for
inpatient hospital procedures.
5. HCPCS Level II codes commonly describe:
A. Diagnoses only
B. Supplies, equipment, drugs, and certain services
C. Inpatient diagnoses
D. Dental procedures exclusively
Answer: B
Rationale: HCPCS Level II supplements CPT by reporting items and
services such as durable medical equipment, supplies, and certain
medications.
6. Which organization maintains CPT?
A. CDC
B. AMA
C. CMS
D. OSHA
Answer: B
Rationale: The American Medical Association maintains CPT.
,7. Which organization administers Medicare?
A. CMS
B. AMA
C. FDA
D. OSHA
Answer: A
Rationale: The Centers for Medicare & Medicaid Services administers
Medicare and oversees Medicaid in partnership with states.
8. What is the first place a coder generally looks when searching for an
ICD-10-CM diagnosis term?
A. Tabular List
B. Alphabetic Index
C. CPT Index
D. HCPCS Table
Answer: B
Rationale: The Alphabetic Index provides the initial location for finding
a diagnosis term.
9. Why must the Tabular List be consulted after using the Alphabetic
Index?
A. To verify the code and review instructions
B. To determine insurance eligibility
C. To calculate coinsurance
D. To identify the patient's provider
Answer: A
Rationale: The Tabular List contains code-specific instructions, inclusion
terms, exclusions, and required specificity.
10. What does an Excludes1 note generally indicate?
A. The conditions should not ordinarily be coded together
, B. The second condition must be coded
C. The code is optional
D. The code is for outpatient use only
Answer: A
Rationale: Excludes1 generally means the excluded condition is not
coded with the code where the note appears.
11. An Excludes2 note indicates that:
A. The excluded condition may be coded separately when appropriate
B. The condition can never be coded
C. The code must be deleted
D. The condition is always principal
Answer: A
Rationale: Excludes2 means the excluded condition is not included in
the code but may coexist and be separately reported.
12. A combination code is used when:
A. One code represents multiple related diagnostic elements
B. A payer rejects a claim
C. A patient has two insurance plans
D. A procedure is performed twice
Answer: A
Rationale: Combination codes capture multiple related elements, such
as a disease with a complication, in a single code when applicable.
13. What does laterality identify?
A. The severity of a condition
B. The side of the body affected
C. The provider's specialty
D. The patient's insurance