NHA Billing And Coding Exam Preparation
Questions With Correct Answers
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?☑️Correct Ans-Coinsurance
The billing and coding specialist should divide the evaluation and management code by which of
the following?☑️Correct Ans-Place of service
The standard medical abbreviation "ECG" refers to a test used to access which of the following
body systems?☑️Correct Ans-Cardiovascular system
In the anesthesia section of the CPT manual, which of the following are considered qualifying
circumstances?☑️Correct Ans-add on codes
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?☑️Correct Ans-12
When submitting a clean claim with a diagnosis of kidney stones, which of the following
procedure names is correct?☑️Correct Ans-Nephrolithiasis
Which of the following is one of the purposes of an internal auditing program in a physician's
office?☑️Correct Ans-Verifying that the medical records and the billing record match
Patient: Jane Austin; Social Security # 555-22-1111; Medicare ID: 555-33-2222A; DOB:
05/22/1945. Claim information entered: Austin, Jane; Social Security #.: 555-22-1111; Medicare
ID No.: 555-33-2222A; DOB: 052245. Which of the following is a reason this claim was
rejected?☑️Correct Ans-The DOB is entered incorrectly
Which of the following options is considered proper supportive documentation for reporting CPT
and ICD codes for surgical procedures?☑️Correct Ans-Operative report
,Which of the following actions should be taken first when reviewing delinquent
claims?☑️Correct Ans-Verify the age of the account
Which of the following components of an explanation of benefits expedites the process of a
phone appeal?☑️Correct Ans-Claim control number
A claim can be denied or rejected for which of the following reasons?☑️Correct Ans-Bloc 24D
contains the diagnosis code
To be compliant with HIPAA, which of the following positions should be assigned in each
office?☑️Correct Ans-Privacy officer
All e-mail correspondence to a third party payer containing patients' protected health information
(PHI) should be☑️Correct Ans-encrypted
A billing and coding specialist should understand that the financial record source that is
generated by a provider's office is called a☑️Correct Ans-patient ledger account
Which of the following includes procedures and best practices for correct coding?☑️Correct
Ans-Coding compliance plan
HIPAA transaction standards apply to which of the following entities?☑️Correct Ans-Health
care clearinghouses
Which of the following actions should be taken if an insurance company denies a service as not
medically necessary?☑️Correct Ans-Appeal the decision with a provider's report
A patient with a past due balance requests that his records be sent to another provider. Which of
the following actions should be taken?☑️Correct Ans-Accommodate the request and send the
records
, 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?☑️Correct Ans-$48
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.☑️Correct Ans-
Deductible
Which of the following is used to code diseases, injuries, impairments, and other health related
problems?☑️Correct Ans-International Classification of Disease (ICD)
Urine moves from the kidneys to the bladder through which of the following parts of the
body?☑️Correct Ans-Ureters
Threading a catheter with a balloon into a coronary artery and expanding it to repair arteries
describes which of the following procedures?☑️Correct Ans-Angioplasty
A patient's portion of the bill should be discussed with the patient before a procedure is
performed for which of the following reasons?☑️Correct Ans-To ensure the patient understands
his portion of the bill
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?☑️Correct Ans-The attending physician
On the CMS-1500 Claims for, blocks 14 through 33 contain information about which of the
following?☑️Correct Ans-The patients condition and the providers information
A provider performs an examination of a patient's throat during an office visit. Which of the
following describes the level of the examination?☑️Correct Ans-Problem focused examination
Questions With Correct Answers
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?☑️Correct Ans-Coinsurance
The billing and coding specialist should divide the evaluation and management code by which of
the following?☑️Correct Ans-Place of service
The standard medical abbreviation "ECG" refers to a test used to access which of the following
body systems?☑️Correct Ans-Cardiovascular system
In the anesthesia section of the CPT manual, which of the following are considered qualifying
circumstances?☑️Correct Ans-add on codes
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?☑️Correct Ans-12
When submitting a clean claim with a diagnosis of kidney stones, which of the following
procedure names is correct?☑️Correct Ans-Nephrolithiasis
Which of the following is one of the purposes of an internal auditing program in a physician's
office?☑️Correct Ans-Verifying that the medical records and the billing record match
Patient: Jane Austin; Social Security # 555-22-1111; Medicare ID: 555-33-2222A; DOB:
05/22/1945. Claim information entered: Austin, Jane; Social Security #.: 555-22-1111; Medicare
ID No.: 555-33-2222A; DOB: 052245. Which of the following is a reason this claim was
rejected?☑️Correct Ans-The DOB is entered incorrectly
Which of the following options is considered proper supportive documentation for reporting CPT
and ICD codes for surgical procedures?☑️Correct Ans-Operative report
,Which of the following actions should be taken first when reviewing delinquent
claims?☑️Correct Ans-Verify the age of the account
Which of the following components of an explanation of benefits expedites the process of a
phone appeal?☑️Correct Ans-Claim control number
A claim can be denied or rejected for which of the following reasons?☑️Correct Ans-Bloc 24D
contains the diagnosis code
To be compliant with HIPAA, which of the following positions should be assigned in each
office?☑️Correct Ans-Privacy officer
All e-mail correspondence to a third party payer containing patients' protected health information
(PHI) should be☑️Correct Ans-encrypted
A billing and coding specialist should understand that the financial record source that is
generated by a provider's office is called a☑️Correct Ans-patient ledger account
Which of the following includes procedures and best practices for correct coding?☑️Correct
Ans-Coding compliance plan
HIPAA transaction standards apply to which of the following entities?☑️Correct Ans-Health
care clearinghouses
Which of the following actions should be taken if an insurance company denies a service as not
medically necessary?☑️Correct Ans-Appeal the decision with a provider's report
A patient with a past due balance requests that his records be sent to another provider. Which of
the following actions should be taken?☑️Correct Ans-Accommodate the request and send the
records
, 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?☑️Correct Ans-$48
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.☑️Correct Ans-
Deductible
Which of the following is used to code diseases, injuries, impairments, and other health related
problems?☑️Correct Ans-International Classification of Disease (ICD)
Urine moves from the kidneys to the bladder through which of the following parts of the
body?☑️Correct Ans-Ureters
Threading a catheter with a balloon into a coronary artery and expanding it to repair arteries
describes which of the following procedures?☑️Correct Ans-Angioplasty
A patient's portion of the bill should be discussed with the patient before a procedure is
performed for which of the following reasons?☑️Correct Ans-To ensure the patient understands
his portion of the bill
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?☑️Correct Ans-The attending physician
On the CMS-1500 Claims for, blocks 14 through 33 contain information about which of the
following?☑️Correct Ans-The patients condition and the providers information
A provider performs an examination of a patient's throat during an office visit. Which of the
following describes the level of the examination?☑️Correct Ans-Problem focused examination
