CBCS Final Practice Test (NHA) Exam Questions And Answers

CBCS Final Practice Test (NHA) Exam Questions And Answers Which of the following is a key protection standard of the HIPAA privacy rule that requires entities and business associates to limit the use or release of protected health information phi)? minimum necessary A billing and coding specialist is preparing a claim that includes code A9698. Which of the following actions should the specialist take to ensure the claim will be paid the first time it is submitted? append the appropriate physical status modifier to the code Brainpower Read More Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:00 / 0:00 Full screen Which of the following describes the status of a claim that is in process and does not include required preauthorization for a service? suspended A third-party payer requests a patients information related to a claim. A billing and coding specialist should ensure that which of the following is included in the patients file before providing the information? signed release of information form A lightning bolt symbol that precedes a code indicates which of the following? code indicates a service is pending FDA approval A billing and coding specialist is using an accounts receivable aging report to determine which accounts should be sent to collection. According to best practice, which of the following accounts should the specialist send to collections? An account that has a balance of $600 and 135 days old. Which of the following CPT codes should a billing and coding specialist use to indicate a total prostate specific antigen (PSA) test? 84153 Which of the following is the purpose of a claims clearinghouse? To identify errors that will prevent a claim from being paid Which of the following describes a claim that is 120 days old? delinquent Which of the following plans requires providers to adhere to managed care provisions? health maintenance organization (HMO) plan According to the ICD-10-CM coding guidelines, the fourth character of an ICD-10-CM diagnosis code indicates which of the following? anatomic site Which of the following codes are used to code diseases, injuries, impairments, and other health-related problems? ICD-10-CM codes An internal retrospective billing account audit prevents fraud and abuse by reviewing and comparing completed claim forms with which of the following? Documentation of compliance plans which of the following types of insurance do health care professionals purchase to protect themselves from liability relating to claims arising from patient treatments? medical malpractice A new patient is seen in the office for frequent urination and excessive thirst. The provider performs a detailed history and examination. Which of the following coding manual should a billing and coding specialist reference to determine the Evaluation and Management (E/M) level of care for the visit? CPT A billing and coding specialist should consider which of the following when determining an evaluation and management (E/M) code. place of service A billing and coding specialist is a preparing a claim for a patient who had an Evaluation and Management (E/M) visit for abdominal pain that resulted in the decision to remove the appendix immediately. Which of the following modifier should use for this claim? 25 modifier patient who has a past due balance requests their records be sent to another provider. Which of the following actions should the billing and coding specialist take with regards to the records request? Begin collection action on the balance due. After a third-party payer validates a claim, which of the following takes place next? Claim adjudication How many days after receipt of an initial demand letter from a Medicare administrative contractor (MAC) does a provider have to return an overpayment of $25 or more without accruing interest? 60 days A billing and coding specialist is conducting an internal audit to analyze reimbursement for a provider practice. Which of the following should the specialist understand is the basis for reimbursement? Diagnosis related group (DRG) billing and coding specialist is preparing to submit a claim for a service that requires preauthorization. Preauthorization must be requested by which of the following individuals? Treating provider Which of the following can be performed when billing procedural codes? Billing using two-digit CPT modifiers to indicate a procedure performed differs from the usual five-digit code A billing and coding specialist is reviewing the CPT coding manual with a trainee. The trainee asks why the Evaluation and Management (E/M) codes are located in the front of the manual since they start with "99" and the rest of the manual is in numeric order. Which of the following statements should specialist make? Evaluation and Management codes are commonly used. a billing and coding specialist is reviewing a patient's progress note, the specialist should identify that which of the following terms indicates a fracture that is related to osteoporosis? pathological fracture A patient who experienced identify theft is trying to investigate how it occurred. The patient asks a billing and coding specialist for assistance in determining if the breach might have originated in the provider's office. Which of the following actions should the specialist take? Notify all patients in the practice about a breach within 60 days