NHA Billing and Coding practice test (CBCS) Questions with Complete Rationales

NHA Billing and Coding practice test (CBCS) Questions with Complete Rationales The attending physician - ANS: A nurse is reviewing a patients lab results prior to discharge and discovers an elevated glucose level. Which of the following health care providers should be altered before the nurse can proceed with discharge planning? The patients condition and the providers information - ANS: On the CMS-1500 Claims for, blocks 14 through 33 contain information about which of the following? Problem focused examination - ANS: A provider performs an examination of a patient's throat during an office visit. Which of the following describes the level of the examination? Reinstated or recycled code - ANS: The symbol "O" in the Current Procedural Terminology reference is used to indicate which of the following? Coinsurance - ANS: Which of the following is the portion of the account balance the patient must pay after services are rendered and the annual deductible is met? Place of service - ANS: The billing and coding specialist should divide the evaluation and management code by which of the following? Cardiovascular system - ANS: The standard medical abbreviation "ECG" refers to a test used to access which of the following body systems? add on codes - ANS: In the anesthesia section of the CPT manual, which of the following are considered qualifying circumstances? 12 - ANS: As of April 1st 2014, what is the maximum number of diagnosis that can be reported on the CMS-1500 claim form before a further claim is required? Nephrolithiasis - ANS: When submitting a clean claim with a diagnosis of kidney stones, which of the following procedure names is correct? Verifying that the medical records and the billing record match - ANS: Which of the following is one of the purposes of an internal auditing program in a physician's office? The DOB is entered incorrectly - ANS: Patient: Jane Austin; Social Security # ; Medicare ID: A; DOB: 05/22/1945. Claim information entered: Austin, Jane; Social Security #.: ; Medicare ID No.: A; DOB: 052245. Which of the following is a reason this claim was rejected? Operative report - ANS: Which of the following options is considered proper supportive documentation for reporting CPT and ICD codes for surgical procedures? Verify the age of the account - ANS: Which of the following actions should be taken first when reviewing delinquent claims? Claim control number - ANS: Which of the following components of an explanation of benefits expedites the process of a phone appeal? Bloc 24D contains the diagnosis code - ANS: A claim can be denied or rejected for which of the following reasons? Privacy officer - ANS: To be compliant with HIPAA, which of the following positions should be assigned in each office? encrypted - ANS: All e-mail correspondence to a third party payer containing patients' protected health information (PHI) should be patient ledger account - ANS: A billing and coding specialist should understand that the financial record source that is generated by a provider's office is called a Coding compliance plan - ANS: Which of the following includes procedures and best practices for correct coding? Health care clearinghouses - ANS: HIPAA transaction standards apply to which of the following entities? Appeal the decision with a provider's report - ANS: Which of the following actions should be taken if an insurance company denies a service as not medically necessary? Accommodate the request and send the records - ANS: A patient with a past due balance requests that his records be sent to another provider. Which of the following actions should be taken? $48 - ANS: A participating BlueCross/ BlueShield (BC/BS) provider receives an explanation of benefits for a patient account. The charged amount was $100. BC/BS allowed $40 to the patients annual deductible. BC/BS paid the balance at 80%. How much should the patient expect to pay? Deductible - ANS: The physician bills $500 to a patient. After submitting the claim to the insurance company, the claim is sent back with no payment. The patient still owes $500 for this year. International Classification of Disease (ICD) - ANS: Which of the following is used to code diseases, injuries, impairments, and other health related problems? Ureters - ANS: Urine moves from the kidneys to the bladder through which of the following parts of the body? Angioplasty - ANS: Threading a catheter with a b