NHA REVIEW ASSESSMENT 3 CERTIFIED
BILLING AND CODING SPECIALIST, CBCS
QUESTIONS AND ANSWERS 100% SOLVED
For each of the following questions, please circle the letter of the most
appropriate response.
1. CPT codes are:
a. Divided into I, II and III groupings
b. Required on submitted claims
c. Published and released January 1st
of every year d. All of the above are
correct
2. Which of the following statements best describes the term, “allowed
amount”?
a. The amount of reimbursement an insurance payer and patient
agree to pay a provider
b. The amount allowed by the provider for supplies
c. The difference between what has been paid by the patient and the
amount billed
d. The difference between the patient’s copayment and what is
owed according to the EOB.
3. HCPCS:
a. Is an acronym meaning, Healthcare Common Procedure Coding
System
b. Is divided into two levels: Level I, CPT codes and Level II,
National Codes
c. Level I codes are maintained by the AMA and Level II codes
are maintained by CMS d. All of the above are correct
,4. When a billing and coding specialist submits a patient’s claim for a
surgical procedure and the insurance company does not require
further review to make payment, this is an example of:
a. A rejected
claim b. A
clean claim
c. An incomplete claim
d. A pending claim
5. A billing and coding specialist should make the following a
priority action in order to identify areas of risk associated with
billing compliance:
a.Conduct educational training
b. Designate a security officer to monitor
compliance c.Develop external audit procedures
d. Perform internal audits to monitor the billing process
,NAME:
6. The organization responsible for conducting investigations and
audits when questions of breaches of protected health information
arise is:
a. HIP
AA b.
OCR
c. OIG
d. All of the above are correct.
7. A billing and coding specialist enters, 99211 on the CMS1500 claim
form and got this code from:
a. HCPCS
b. CPT manual
c. ICD manual
d. NPI
8. ICD-10-CM is viewed as an improvement from ICD-9-CM because:
a. It contains new chapters and categories
b. The V and E codes have been incorporated into the main
classification system
c. The codes are more specific and therefore provide
more information d. All of the above are correct
9. The following is required if a procedure might not be
covered by Medicare: a. ABN
b. COB
c. CMS
d. AOB
2|P a g e
, NAME:
10. In the charge capture process, a billing and coding specialist needs
to verify code linkage to ensure:
a. Correct encounter documentation
b. Claim
scrubbing c.
Medical
necessity
d. Allowed amount for procedures
11. If this is missing from a claim form, it can
delay processing: a. Secondary insurance
b. Medical record number
c. Units of service
d. Telephone number
3|P a g e
BILLING AND CODING SPECIALIST, CBCS
QUESTIONS AND ANSWERS 100% SOLVED
For each of the following questions, please circle the letter of the most
appropriate response.
1. CPT codes are:
a. Divided into I, II and III groupings
b. Required on submitted claims
c. Published and released January 1st
of every year d. All of the above are
correct
2. Which of the following statements best describes the term, “allowed
amount”?
a. The amount of reimbursement an insurance payer and patient
agree to pay a provider
b. The amount allowed by the provider for supplies
c. The difference between what has been paid by the patient and the
amount billed
d. The difference between the patient’s copayment and what is
owed according to the EOB.
3. HCPCS:
a. Is an acronym meaning, Healthcare Common Procedure Coding
System
b. Is divided into two levels: Level I, CPT codes and Level II,
National Codes
c. Level I codes are maintained by the AMA and Level II codes
are maintained by CMS d. All of the above are correct
,4. When a billing and coding specialist submits a patient’s claim for a
surgical procedure and the insurance company does not require
further review to make payment, this is an example of:
a. A rejected
claim b. A
clean claim
c. An incomplete claim
d. A pending claim
5. A billing and coding specialist should make the following a
priority action in order to identify areas of risk associated with
billing compliance:
a.Conduct educational training
b. Designate a security officer to monitor
compliance c.Develop external audit procedures
d. Perform internal audits to monitor the billing process
,NAME:
6. The organization responsible for conducting investigations and
audits when questions of breaches of protected health information
arise is:
a. HIP
AA b.
OCR
c. OIG
d. All of the above are correct.
7. A billing and coding specialist enters, 99211 on the CMS1500 claim
form and got this code from:
a. HCPCS
b. CPT manual
c. ICD manual
d. NPI
8. ICD-10-CM is viewed as an improvement from ICD-9-CM because:
a. It contains new chapters and categories
b. The V and E codes have been incorporated into the main
classification system
c. The codes are more specific and therefore provide
more information d. All of the above are correct
9. The following is required if a procedure might not be
covered by Medicare: a. ABN
b. COB
c. CMS
d. AOB
2|P a g e
, NAME:
10. In the charge capture process, a billing and coding specialist needs
to verify code linkage to ensure:
a. Correct encounter documentation
b. Claim
scrubbing c.
Medical
necessity
d. Allowed amount for procedures
11. If this is missing from a claim form, it can
delay processing: a. Secondary insurance
b. Medical record number
c. Units of service
d. Telephone number
3|P a g e
