NHA CBCS Practice Questions (Set 2) With
Correct Answers
Which of the following is considered Protected Health Information (PHI)
| | | | | | | | | |
under the Health Insurance Portability and Accountability Act (HIPPA)?
| | | | | | | |
Patient's email address | |
Emily, a 45-year old patient, has recently been diagnosed with a chronic
| | | | | | | | | | | |
condition that requires ongoing treatment. Her primary insurance is
| | | | | | | | |
through her employer, but she also has a secondary insurance through
| | | | | | | | | | |
her spouse's employer. When submitting claims for Emily's treatment,
| | | | | | | | |
what is the correct order of billing to ensure proper coordination of
| | | | | | | | | | | |
benefits?
Submit the claim to the primary insurance first, then the secondary
| | | | | | | | | | |
insurance
Dr. Smith preformed a minor surgical procedure on John Doe at an
| | | | | | | | | | | |
outpatient surgery center. Which place of service code should be used for
| | | | | | | | | | | |
this procedure?
|
24- procedures performed in an ambulatory surgery center ASC)
| | | | | | | |
,Sarah, a medical billing specialist, is reviewing the account of a patient
| | | | | | | | | | | |
named John Doe. She notices that the insurance company has a lack of
| | | | | | | | | | | | |
pre-authorization for a specific procedure. What is the best course of | | | | | | | | | | |
action for Sarah to take to resolve this issue?
| | | | | | | |
Obtain the necessary pre-authorization and then resubmit the claim
| | | | | | | |
Dr. Smith is submitting a CMS-1500 claim form for patient named John
| | | | | | | | | | | |
Doe, who received outpatient services covered by medicare. Which
| | | | | | | | |
section of the CMS-1500 form should Dr. Smith complete to indicate the
| | | | | | | | | | | |
type of insurance plan covering John Doe?
| | | | | |
- Box 1a- insured's ID Number
| | | | |
- Box 11- Insured Policy Group or FECA number
| | | | | | | |
- Box 1- Insurance Type
| | | |
- Box 24- Service Line Information
| | | | |
Box 1- Insurance Type
| | |
Which of the following is a primary purpose of internal audits in the
| | | | | | | | | | | | |
context of medical billing and coding?
| | | | |
To identify the correct coding errors before claim submissions
| | | | | | | |
,Dr. Smith's office received a request from John Does insurance company
| | | | | | | | | | |
for his medical records to process a claim. According to HIPPA regulations,
| | | | | | | | | | | |
what is the most appropriate action for Dr. Smith's office to take?
| | | | | | | | | | |
Provide only the minimum necessary information required to process the
| | | | | | | | | |
claim
When coding for Obstetrics, which of the following codes is used to
| | | | | | | | | | | |
indicate a routine prenatal visit with no complications?
| | | | | | |
- Z34.00: Routine prenatal for normal first pregnancy no complications
| | | | | | | | |
- O09.89: Supervision of high risk pregnancy
| | | | | |
- Z33.1: Encounter for pregnancy test
| | | | |
- O10.11: Pre-existing hypertension complicating pregnancy
| | | | |
Z34.00: Routine prenatal for normal first pregnancy no complications
| | | | | | | |
Sarah, a patient. has recently filled for bankruptcy. As a medical billing
| | | | | | | | | | | |
specialist, what is the appropriate action to take regarding her
| | | | | | | | | |
outstanding medical bills? | |
Cease all collection activities and notify the bankruptcy court
| | | | | | | |
, When coding for telemedicine services, which modifier should be
| | | | | | | | |
appended to indicate the service was provided via Telehealth?
| | | | | | | |
Modifier 95 |
When a patient has multiple insurance plans, which insurance plan is
| | | | | | | | | | |
typically considered the primary insurance?
| | | |
The insurance plan provided by the patients employer
| | | | | | |
Sarah, a medical billing specialist, is verifying insurance eligibility for a
| | | | | | | | | | |
patient named John who has a commercial insurance plan. Which of the
| | | | | | | | | | | |
following is a requirement she must fulfill to ensure that John's insurance
| | | | | | | | | | | |
eligibility is verified correctly?
| | |
Confirm the patient's policy number and group number
| | | | | | |
Which of the following is the most crucial step in ensuring all applicable
| | | | | | | | | | | | |
charges are captured for optimal reimbursement?
| | | | |
Reviewing patient encounter forms and progress notes
| | | | | |
Correct Answers
Which of the following is considered Protected Health Information (PHI)
| | | | | | | | | |
under the Health Insurance Portability and Accountability Act (HIPPA)?
| | | | | | | |
Patient's email address | |
Emily, a 45-year old patient, has recently been diagnosed with a chronic
| | | | | | | | | | | |
condition that requires ongoing treatment. Her primary insurance is
| | | | | | | | |
through her employer, but she also has a secondary insurance through
| | | | | | | | | | |
her spouse's employer. When submitting claims for Emily's treatment,
| | | | | | | | |
what is the correct order of billing to ensure proper coordination of
| | | | | | | | | | | |
benefits?
Submit the claim to the primary insurance first, then the secondary
| | | | | | | | | | |
insurance
Dr. Smith preformed a minor surgical procedure on John Doe at an
| | | | | | | | | | | |
outpatient surgery center. Which place of service code should be used for
| | | | | | | | | | | |
this procedure?
|
24- procedures performed in an ambulatory surgery center ASC)
| | | | | | | |
,Sarah, a medical billing specialist, is reviewing the account of a patient
| | | | | | | | | | | |
named John Doe. She notices that the insurance company has a lack of
| | | | | | | | | | | | |
pre-authorization for a specific procedure. What is the best course of | | | | | | | | | | |
action for Sarah to take to resolve this issue?
| | | | | | | |
Obtain the necessary pre-authorization and then resubmit the claim
| | | | | | | |
Dr. Smith is submitting a CMS-1500 claim form for patient named John
| | | | | | | | | | | |
Doe, who received outpatient services covered by medicare. Which
| | | | | | | | |
section of the CMS-1500 form should Dr. Smith complete to indicate the
| | | | | | | | | | | |
type of insurance plan covering John Doe?
| | | | | |
- Box 1a- insured's ID Number
| | | | |
- Box 11- Insured Policy Group or FECA number
| | | | | | | |
- Box 1- Insurance Type
| | | |
- Box 24- Service Line Information
| | | | |
Box 1- Insurance Type
| | |
Which of the following is a primary purpose of internal audits in the
| | | | | | | | | | | | |
context of medical billing and coding?
| | | | |
To identify the correct coding errors before claim submissions
| | | | | | | |
,Dr. Smith's office received a request from John Does insurance company
| | | | | | | | | | |
for his medical records to process a claim. According to HIPPA regulations,
| | | | | | | | | | | |
what is the most appropriate action for Dr. Smith's office to take?
| | | | | | | | | | |
Provide only the minimum necessary information required to process the
| | | | | | | | | |
claim
When coding for Obstetrics, which of the following codes is used to
| | | | | | | | | | | |
indicate a routine prenatal visit with no complications?
| | | | | | |
- Z34.00: Routine prenatal for normal first pregnancy no complications
| | | | | | | | |
- O09.89: Supervision of high risk pregnancy
| | | | | |
- Z33.1: Encounter for pregnancy test
| | | | |
- O10.11: Pre-existing hypertension complicating pregnancy
| | | | |
Z34.00: Routine prenatal for normal first pregnancy no complications
| | | | | | | |
Sarah, a patient. has recently filled for bankruptcy. As a medical billing
| | | | | | | | | | | |
specialist, what is the appropriate action to take regarding her
| | | | | | | | | |
outstanding medical bills? | |
Cease all collection activities and notify the bankruptcy court
| | | | | | | |
, When coding for telemedicine services, which modifier should be
| | | | | | | | |
appended to indicate the service was provided via Telehealth?
| | | | | | | |
Modifier 95 |
When a patient has multiple insurance plans, which insurance plan is
| | | | | | | | | | |
typically considered the primary insurance?
| | | |
The insurance plan provided by the patients employer
| | | | | | |
Sarah, a medical billing specialist, is verifying insurance eligibility for a
| | | | | | | | | | |
patient named John who has a commercial insurance plan. Which of the
| | | | | | | | | | | |
following is a requirement she must fulfill to ensure that John's insurance
| | | | | | | | | | | |
eligibility is verified correctly?
| | |
Confirm the patient's policy number and group number
| | | | | | |
Which of the following is the most crucial step in ensuring all applicable
| | | | | | | | | | | | |
charges are captured for optimal reimbursement?
| | | | |
Reviewing patient encounter forms and progress notes
| | | | | |
