NHA NEW CBCS PRACTICE TESTS,
EXAM QUESTIONS 2025. (CORRECT
ANSWERS)
Medical Ethics - correct answer Standards of conduct based on moral principles. Generally accepted as a
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guide for behavior towards patients, physicians, co-workers, the government, and insurance compaines.
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Compliance Regulations - correct answer billing-related cases are based on HIPAA and False Claims Act.
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Health Insurance Portability and Accountability Act of 1996 (HIPPA) - correct answer Created the Health Care
q q q q q q q q q q q q q q q q
Frad and Abuse Control Prpgram enacted nt check for fraud and abuse in the Medicare and Medicaid
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programs, and private payers. q q q
Two provisions of HIPPA - correct answer Titile I: Insurance Reform
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Title II: Administrative Simplification
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Insurance Reform - correct answer -Primary purpose to provide continuous insurance coverage for workers
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and their dependents when they change or lose their jobs.
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-Limits the use of preexisting conditions exclusions
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-Prohibits discrimination for part or present poor health
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-Guarantees cetraom employees and individuals the right to purchase health insurance coverage after losing
q q q q q q q q q q q q q q
a job
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,- Allows renewal of health insurance coverage regardless of an individual's health condition that is covered
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under the particular policy
q q q
Administrative Simplification - correct answer -The goal is to focus on the health care practice setting to q q q q q q q q q q q q q q q q q
reduce administrative cost and burdens.
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Two parts:
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1. Development and implementation of standardized health-related financial and administrative activities
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electronically.
2. Implementation of privacy and security procedures to prevent the misuse of health information by
q q q q q q q q q q q q q q q
ensuring confidentiality. q
False Claim Act (FCA) - correct answer Federal law that prohibits submittimg a fraudulent claim or making
q q q q q q q q q q q q q q q q q
statement or representation in connection with a claim. q q q q q q q
National Correct Coding Initiative (NCCI) - correct answer Developed by the CMS to promote national correct
q q q q q q q q q q q q q q q q
coding methodologies and to control improper coding that leads to inappropriate payment of part B health
q q q q q q q q q q q q q q q q
insurance claims. q
Two type of NCCA edits - correct answer 1. Column1/Column 2(perviously called Comprehensive
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Component) Edits:identifies code pairs that should not be billed together because one code (Column 1)
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includes all the services described by another code (Column 2).
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2. Muttually Exclusive Edits: identifeis code pairs that, for clinical reason, are unlikely to be performed on the
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same patient on the same day.
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Office of Inspector General (OIG) - correct answer Investigates and prosecute health care fraud and abuse.
q q q q q q q q q q q q q q q
Fraud - correct answer Knowingly and intentionally deceiving or misrepresenting information that may result
q q q q q q q q q q q q q q
in unauthorized benefits.
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Abuse - correct answer Defined as incidents or practices, not usually considered fradulaent that are
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inconsistant with the accepted medical business or fiscal practices in the industry. q q q q q q q q q q q
,Patient Confidentiality - correct answer A;ll patients have the right to privacy, and all information should
q q q q q q q q q q q q q q q q
remain privileged. Discuss patient information with only the patient's physician or office personnel that need
q q q q q q q q q q q q q q q
cetain information to do their job. Obtained a signed consent form to release medical infomation to the
q q q q q q q q q q q q q q q q q
insurance company or other individual. q q q q
Under HIPPA Privacy Rule, providers may use patient's Protected Health Information (PHI) without specific
q q q q q q q q q q q q q q
authorization for - correct answer Treatment: primarily for the purpose of discussion fo the patient's case
q q q q q q q q q q q q q q q q
with other providers.
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Payment: providers submit claims on behalf of patients.
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Operations: for purposes such as stafff training and quality improvment. q q q q q q q q q
Employern Liability - correct answer Physicians are legally responsible for their own conduct and any action of
q q q q q q q q q q q q q q q q q
their employees (their designee) perform within the context of their employment. Refered to as "vacarious
q q q q q q q q q q q q q q q
liability"also known as "respondent superior" which means "let the master answer". q q q q q q q q q q
Employee Liabiltiy - correct answer "Errors and omissions insurance" is protection against loss of monies by
q q q q q q q q q q q q q q q q
failure through error or unintentional omission on the part of the individual or service submitting the
q q q q q q q q q q q q q q q q
insurance claim. q
Medical Records - correct answer Documentaiton of the patient's social and medical history, family history,
q q q q q q q q q q q q q q q
physical examination findings, progress notes, radiology, and lab results, consultation reports, and
q q q q q q q q q q q q
correspondence to patient. q q
Information needed when billing the insurance company - correct answer Date of service (DOS), place of
q q q q q q q q q q q q q q q q
service (POS), type of service (TOS), diagnosis (dx or DX), and procedures.
q q q q q q q q q q q
Retention of Medical Records - correct answer Governed by state and local laws and may bary from state-to-
q q q q q q q q q q q q q q q q q
state. Most physicians are required to retain records indefinitley; deceased patient records should be kept for
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at least (5) years.
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New patient - correct answer one who has not received any medical services within the last 3 years
q q q q q q q q q q q q q q q q q
Established patient - correct answer someone who has received medical services in the last 3 years from the
q q q q q q q q q q q q q q q q q q
physician or another physician of the same specialty who belong to the same group practice.
q q q q q q q q q q q q q q
, cheif complaint - correct answer brief statement describing they symptom, problem, diagnosis, or condition
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that is the reason a patient seeks medical care.
q q q q q q q q
3 volumns of ICD-9 manal - correct answer Volumn 1-Diseases: Tabular List
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Volumn 2-Diseases: Alphabetic Index
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Volumn 1 and 2 are used in the inpatient and outpatient setting
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Volumn 3- Procedures:Tabular List and Alphabetic Index
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Volumn 1 - Diseases: Tabular List - correct answer -contains the diease and condition code and the
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descriptions
- also contains the V codes and E codes
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Volumn 2 - Diseases: Alphabetic Index - correct answer alphabetic index of volumn 1
q q q q q q q q q q q q q
Volumn 3 - Tabular List and Alphabetic Index - correct answer contains codes for surgical, therapeutic, and
q q q q q q q q q q q q q q q q q
diagnostic procedures; used primarily by hospitals q q q q q
Hypertension classifications: - correct answer Maligant- an accelerated, severe form of hypertension with
q q q q q q q q q q q q q
vascular damage and a diastolic pressure of 130mmHg or greater.
q q q q q q q q q
Benign- Mild or controlled hypertension and no damage to the vascular system or organs.
q q q q q q q q q q q q q
Unspecified- not specified as bengin or malignant in the diagnosis or medical record.
q q q q q q q q q q q q
malignant neoplasm - correct answer further classified as to primary , secondary, or cacinoma in situ
q q q q q q q q q q q q q q q
primary malignancy - correct answer original cancer site. Malignant tumors are considered primary unless
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documented as secondary or metastatic q q q q
carcinoma in situ - correct answer cancer that is localized and has not spread to adjacent tissue or distant parts
q q q q q q q q q q q q q q q q q q q
of the body
q q q
EXAM QUESTIONS 2025. (CORRECT
ANSWERS)
Medical Ethics - correct answer Standards of conduct based on moral principles. Generally accepted as a
q q q q q q q q q q q q q q q q
guide for behavior towards patients, physicians, co-workers, the government, and insurance compaines.
q q q q q q q q q q q
Compliance Regulations - correct answer billing-related cases are based on HIPAA and False Claims Act.
q q q q q q q q q q q q q q
Health Insurance Portability and Accountability Act of 1996 (HIPPA) - correct answer Created the Health Care
q q q q q q q q q q q q q q q q
Frad and Abuse Control Prpgram enacted nt check for fraud and abuse in the Medicare and Medicaid
q q q q q q q q q q q q q q q q q
programs, and private payers. q q q
Two provisions of HIPPA - correct answer Titile I: Insurance Reform
q q q q q q q q q q
Title II: Administrative Simplification
q q q
Insurance Reform - correct answer -Primary purpose to provide continuous insurance coverage for workers
q q q q q q q q q q q q q q
and their dependents when they change or lose their jobs.
q q q q q q q q q
-Limits the use of preexisting conditions exclusions
q q q q q q
-Prohibits discrimination for part or present poor health
q q q q q q q
-Guarantees cetraom employees and individuals the right to purchase health insurance coverage after losing
q q q q q q q q q q q q q q
a job
q
,- Allows renewal of health insurance coverage regardless of an individual's health condition that is covered
q q q q q q q q q q q q q q q q
under the particular policy
q q q
Administrative Simplification - correct answer -The goal is to focus on the health care practice setting to q q q q q q q q q q q q q q q q q
reduce administrative cost and burdens.
q q q q
Two parts:
q
1. Development and implementation of standardized health-related financial and administrative activities
q q q q q q q q q q q
electronically.
2. Implementation of privacy and security procedures to prevent the misuse of health information by
q q q q q q q q q q q q q q q
ensuring confidentiality. q
False Claim Act (FCA) - correct answer Federal law that prohibits submittimg a fraudulent claim or making
q q q q q q q q q q q q q q q q q
statement or representation in connection with a claim. q q q q q q q
National Correct Coding Initiative (NCCI) - correct answer Developed by the CMS to promote national correct
q q q q q q q q q q q q q q q q
coding methodologies and to control improper coding that leads to inappropriate payment of part B health
q q q q q q q q q q q q q q q q
insurance claims. q
Two type of NCCA edits - correct answer 1. Column1/Column 2(perviously called Comprehensive
q q q q q q q q q q q q q
Component) Edits:identifies code pairs that should not be billed together because one code (Column 1)
q q q q q q q q q q q q q q q
includes all the services described by another code (Column 2).
q q q q q q q q q
2. Muttually Exclusive Edits: identifeis code pairs that, for clinical reason, are unlikely to be performed on the
q q q q q q q q q q q q q q q q q q
same patient on the same day.
q q q q q
Office of Inspector General (OIG) - correct answer Investigates and prosecute health care fraud and abuse.
q q q q q q q q q q q q q q q
Fraud - correct answer Knowingly and intentionally deceiving or misrepresenting information that may result
q q q q q q q q q q q q q q
in unauthorized benefits.
q q
Abuse - correct answer Defined as incidents or practices, not usually considered fradulaent that are
q q q q q q q q q q q q q q q
inconsistant with the accepted medical business or fiscal practices in the industry. q q q q q q q q q q q
,Patient Confidentiality - correct answer A;ll patients have the right to privacy, and all information should
q q q q q q q q q q q q q q q q
remain privileged. Discuss patient information with only the patient's physician or office personnel that need
q q q q q q q q q q q q q q q
cetain information to do their job. Obtained a signed consent form to release medical infomation to the
q q q q q q q q q q q q q q q q q
insurance company or other individual. q q q q
Under HIPPA Privacy Rule, providers may use patient's Protected Health Information (PHI) without specific
q q q q q q q q q q q q q q
authorization for - correct answer Treatment: primarily for the purpose of discussion fo the patient's case
q q q q q q q q q q q q q q q q
with other providers.
q q
Payment: providers submit claims on behalf of patients.
q q q q q q q
Operations: for purposes such as stafff training and quality improvment. q q q q q q q q q
Employern Liability - correct answer Physicians are legally responsible for their own conduct and any action of
q q q q q q q q q q q q q q q q q
their employees (their designee) perform within the context of their employment. Refered to as "vacarious
q q q q q q q q q q q q q q q
liability"also known as "respondent superior" which means "let the master answer". q q q q q q q q q q
Employee Liabiltiy - correct answer "Errors and omissions insurance" is protection against loss of monies by
q q q q q q q q q q q q q q q q
failure through error or unintentional omission on the part of the individual or service submitting the
q q q q q q q q q q q q q q q q
insurance claim. q
Medical Records - correct answer Documentaiton of the patient's social and medical history, family history,
q q q q q q q q q q q q q q q
physical examination findings, progress notes, radiology, and lab results, consultation reports, and
q q q q q q q q q q q q
correspondence to patient. q q
Information needed when billing the insurance company - correct answer Date of service (DOS), place of
q q q q q q q q q q q q q q q q
service (POS), type of service (TOS), diagnosis (dx or DX), and procedures.
q q q q q q q q q q q
Retention of Medical Records - correct answer Governed by state and local laws and may bary from state-to-
q q q q q q q q q q q q q q q q q
state. Most physicians are required to retain records indefinitley; deceased patient records should be kept for
q q q q q q q q q q q q q q q
at least (5) years.
q q q q
New patient - correct answer one who has not received any medical services within the last 3 years
q q q q q q q q q q q q q q q q q
Established patient - correct answer someone who has received medical services in the last 3 years from the
q q q q q q q q q q q q q q q q q q
physician or another physician of the same specialty who belong to the same group practice.
q q q q q q q q q q q q q q
, cheif complaint - correct answer brief statement describing they symptom, problem, diagnosis, or condition
q q q q q q q q q q q q q q
that is the reason a patient seeks medical care.
q q q q q q q q
3 volumns of ICD-9 manal - correct answer Volumn 1-Diseases: Tabular List
q q q q q q q q q q q q
Volumn 2-Diseases: Alphabetic Index
q q q
Volumn 1 and 2 are used in the inpatient and outpatient setting
q q q q q q q q q q q
Volumn 3- Procedures:Tabular List and Alphabetic Index
q q q q q q
Volumn 1 - Diseases: Tabular List - correct answer -contains the diease and condition code and the
q q q q q q q q q q q q q q q q q
descriptions
- also contains the V codes and E codes
q q q q q q q q
Volumn 2 - Diseases: Alphabetic Index - correct answer alphabetic index of volumn 1
q q q q q q q q q q q q q
Volumn 3 - Tabular List and Alphabetic Index - correct answer contains codes for surgical, therapeutic, and
q q q q q q q q q q q q q q q q q
diagnostic procedures; used primarily by hospitals q q q q q
Hypertension classifications: - correct answer Maligant- an accelerated, severe form of hypertension with
q q q q q q q q q q q q q
vascular damage and a diastolic pressure of 130mmHg or greater.
q q q q q q q q q
Benign- Mild or controlled hypertension and no damage to the vascular system or organs.
q q q q q q q q q q q q q
Unspecified- not specified as bengin or malignant in the diagnosis or medical record.
q q q q q q q q q q q q
malignant neoplasm - correct answer further classified as to primary , secondary, or cacinoma in situ
q q q q q q q q q q q q q q q
primary malignancy - correct answer original cancer site. Malignant tumors are considered primary unless
q q q q q q q q q q q q q q
documented as secondary or metastatic q q q q
carcinoma in situ - correct answer cancer that is localized and has not spread to adjacent tissue or distant parts
q q q q q q q q q q q q q q q q q q q
of the body
q q q
