CBCS Practice Test Questions and Correct
Answers
Question 1
Accepting assignment on the CMS-1500 claim form indicates which of the following?
-The patient agrees to accept payment and forward the payment to the physician
-The physician agrees to accept payment under the terms of the payer's program.
-The physician agrees to bill according the third payer's fee schedule
-The patient agrees to pay the difference between the billed amount and the allowed
amount
Correct Answer
The physician agrees to accept payment under the terms of the payer's program.
Question 2
A CBCS should enter the prior authorization number on the CMS-1500 claim form in
which of the following blocks?
- 21A (diagnosis code)
- 24 D (procedures and services)
- 23 (prior authorization)
- 24E (federal tax id)
Correct Answer
23 (prior authorization)
- 21A (diagnosis code)
- 24 D (procedures and services)
- 24E (federal tax id)
Page 1 of 88
,Question 3
Which of the following is the verbal or written agreement that gives approval to some
action, situation, or statement and allows the release of patient information?
- Compliance agreement (prevents fraudulent activities)
- Security rule agreement
- Consent agreement
- HIPAA
Correct Answer
consent agreement
Question 4
A claim is denied because the service was not covered by the insurance. Upon
confirmation of no errors on the claim, which of the following describes the process
that will follow the denial?
- The claim will be submitted with a new CPT code
- The claim will not be resubmitted and the patient will be sent a bill
- The claim will be resubmitted with a modifier on the CPT code
- The claim will not be resubmitted, but the claim will be appealed.
Correct Answer
The claim will not be resubmitted and the patient will be sent a bill
Question 5
Which of the following components of an explanation of benefits expedites the
process of a phone appeal?
- NPI number
- Claim control number
- Insured's ID number
- Check number
Correct Answer
Claim control number
Page 2 of 88
,Question 6
Which of the following describes the reason for a claim rejection because of Medicare
NCCI edits?
- Reporting codes without proper modifiers
- Coding without proper documentation
- Improper code combination
- Use of outdated codes
Correct Answer
improper code combination
Question 7
Which of the following is used by providers to remove errors from claims before they
are submitted to third party payers?
- National committee for quality assurance
- HIPAA transaction and code sets (TCS)
- Correct coding initiative (CCI)
- clearinghouse
Correct Answer
clearinghouse
- National committee for quality assurance (report standards that compare
performance between health care plans)
- HIPAA transaction and code sets (TCS) (standardizes electronic claim transactions)
- Correct coding initiative (CCI) ( prevents unbundling)
Question 8
A CBCS should add modifier -50 to codes when reporting which of the following?
- A bilateral procedure
- A unilateral procedure
- Multiple procedure
- Reduces services
Correct Answer
A bilateral procedure
Page 3 of 88
, Question 9
Threatening a catheter with a balloon into a coronary artery and expanding it to
repair arteries describes which of the following procedures?
- Valvuloplasty
- Atherectomy
- Angioplasty
- Ablation
Correct Answer
Angioplasty
- Valvuloplasty (open a stenotic heart valve)
- Atherectomy (Non surgical procedure to open blocked coronary arteries or vein
grafts by using a device on the end of a catheter to cut or shave away
atherosclerotic plaque. It does not us a balloon.
- Ablation (radio frequency waves of the heart is used to cure a variety of cardiac
arrhythmia.)
Question 10
Which of the following actions should the CBCS take to effectively manage accounts
receivable?
-Collect payment from the patient at the time of service
-Have the patient pat the balance up front and wait for reimbursement
-Delay submission until the patient pays the deductible
-Ask the patient to pay half now and bill the insurance for the balance
Correct Answer
Collect payment from the patient at the time of service
Question 11
Which of the following steps would be part of a physician's practice compliance
program?
-HIPAA compliance audit
-Physician recruitment
-Internal monitoring and auditing
-Notice of privacy practice
Correct Answer
Internal monitoring and auditing
Page 4 of 88
Answers
Question 1
Accepting assignment on the CMS-1500 claim form indicates which of the following?
-The patient agrees to accept payment and forward the payment to the physician
-The physician agrees to accept payment under the terms of the payer's program.
-The physician agrees to bill according the third payer's fee schedule
-The patient agrees to pay the difference between the billed amount and the allowed
amount
Correct Answer
The physician agrees to accept payment under the terms of the payer's program.
Question 2
A CBCS should enter the prior authorization number on the CMS-1500 claim form in
which of the following blocks?
- 21A (diagnosis code)
- 24 D (procedures and services)
- 23 (prior authorization)
- 24E (federal tax id)
Correct Answer
23 (prior authorization)
- 21A (diagnosis code)
- 24 D (procedures and services)
- 24E (federal tax id)
Page 1 of 88
,Question 3
Which of the following is the verbal or written agreement that gives approval to some
action, situation, or statement and allows the release of patient information?
- Compliance agreement (prevents fraudulent activities)
- Security rule agreement
- Consent agreement
- HIPAA
Correct Answer
consent agreement
Question 4
A claim is denied because the service was not covered by the insurance. Upon
confirmation of no errors on the claim, which of the following describes the process
that will follow the denial?
- The claim will be submitted with a new CPT code
- The claim will not be resubmitted and the patient will be sent a bill
- The claim will be resubmitted with a modifier on the CPT code
- The claim will not be resubmitted, but the claim will be appealed.
Correct Answer
The claim will not be resubmitted and the patient will be sent a bill
Question 5
Which of the following components of an explanation of benefits expedites the
process of a phone appeal?
- NPI number
- Claim control number
- Insured's ID number
- Check number
Correct Answer
Claim control number
Page 2 of 88
,Question 6
Which of the following describes the reason for a claim rejection because of Medicare
NCCI edits?
- Reporting codes without proper modifiers
- Coding without proper documentation
- Improper code combination
- Use of outdated codes
Correct Answer
improper code combination
Question 7
Which of the following is used by providers to remove errors from claims before they
are submitted to third party payers?
- National committee for quality assurance
- HIPAA transaction and code sets (TCS)
- Correct coding initiative (CCI)
- clearinghouse
Correct Answer
clearinghouse
- National committee for quality assurance (report standards that compare
performance between health care plans)
- HIPAA transaction and code sets (TCS) (standardizes electronic claim transactions)
- Correct coding initiative (CCI) ( prevents unbundling)
Question 8
A CBCS should add modifier -50 to codes when reporting which of the following?
- A bilateral procedure
- A unilateral procedure
- Multiple procedure
- Reduces services
Correct Answer
A bilateral procedure
Page 3 of 88
, Question 9
Threatening a catheter with a balloon into a coronary artery and expanding it to
repair arteries describes which of the following procedures?
- Valvuloplasty
- Atherectomy
- Angioplasty
- Ablation
Correct Answer
Angioplasty
- Valvuloplasty (open a stenotic heart valve)
- Atherectomy (Non surgical procedure to open blocked coronary arteries or vein
grafts by using a device on the end of a catheter to cut or shave away
atherosclerotic plaque. It does not us a balloon.
- Ablation (radio frequency waves of the heart is used to cure a variety of cardiac
arrhythmia.)
Question 10
Which of the following actions should the CBCS take to effectively manage accounts
receivable?
-Collect payment from the patient at the time of service
-Have the patient pat the balance up front and wait for reimbursement
-Delay submission until the patient pays the deductible
-Ask the patient to pay half now and bill the insurance for the balance
Correct Answer
Collect payment from the patient at the time of service
Question 11
Which of the following steps would be part of a physician's practice compliance
program?
-HIPAA compliance audit
-Physician recruitment
-Internal monitoring and auditing
-Notice of privacy practice
Correct Answer
Internal monitoring and auditing
Page 4 of 88
