NHA CBCS 3.0 PRACTICE TEST EXAM
2025. (CORRECT ANSWERS)
A child is brought into a facility by their mother. The child is covered under both parents' insurance policies.
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The child's father was born on 10/1/1980 and their mother was born on 10/2/1981. Which of the following
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statements is true regarding the primary policy holder for the child? - correct answer The father is the primary
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policy holder because his birthday falls first in the calendar year.
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A billing and coding specialist is submitting a claim for a school-age child who was brought to the clinic by their
w w w w w w w w w w w w w w w w w w w w w
maternal grandmother. The child's parents are divorced and remarried, and the child's mother has legal
w w w w w w w w w w w w w w w
custody of the child. The specialist should recognize that the child's primary insurance coverage is provided
w w w w w w w w w w w w w w w w
through which of the following insured individuals? - correct answer Biologic mother
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Which of the following is the purpose of running an insurance aging report each month? - correct answer To
w w w w w w w w w w w w w w w w w w w
determine which claims are outstanding from third-party payers
w w w w w w w
A billing and coding specialist observes a colleague perform an unethical act. Which of the following actions
w w w w w w w w w w w w w w w w w
should the specialist take? - correct answer Report the incident to a supervisor
w w w w w w w w w w w w
Which of the following statements is true regarding the release of patients records? - correct answer Patient
w w w w w w w w w w w w w w w w w
access to psychotherapy notes is restricted
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,A billing and coding specialist is preparing a claim for a patient who had a procedure performed on their left
w w w w w w w w w w w w w w w w w w w w
index finger. Which of the following modifiers indicates the correct digit? - correct answer -F1
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-FA: used for left thumb
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-F6: used for right index finger
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-F4: used for the left pinky
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A billing and coding specialist is processing a claim for a patient who broke their arm while repairing cars at
w w w w w w w w w w w w w w w w w w w w
their workplace. There is no nerve damage, the arm is placed in a cast for 6 weeks, and the patient is cleared to
w w w w w w w w w w w w w w w w w w w w w w
return to work in 6 weeks. Which of the following types of workers' compensation applies to this patient? -
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correct answer Temporary disability w w w
Based on the CPT integumentary coding guidelines, Mohs micrographic surgery involves the provider filling
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which of the following roles? - correct answer Both the surgeon and pathologist
w w w w w w w w w w w w
A billing and coding specialist is preparing a claim for a provider. The operative note indicates the surgeon
w w w w w w w w w w w w w w w w w w
performed a CABG. The specialist should identify that CABG stands for which of the following? - correct
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answer Coronary Artery Bypass Graft w w w w
A billing and coding specialist is arranging a payment plan with a patient who wants to leave postdated checks
w w w w w w w w w w w w w w w w w w
with the office. The patient proposes leaving one check postdated for 3 months, one for 4 months, and
w w w w w w w w w w w w w w w w w w w
another one for 5 months in the future. According to federal collection law, which of the following actions
w w w w w w w w w w w w w w w w w w
should the specialist take? - correct answer Notify the patient between 3 and 10 days prior to depositing each
w w w w w w w w w w w w w w w w w w w
check on the indicated date.w w w w
Which of the following qualifies a patient for eligibility under Medicare as the primary third-party payer? -
w w w w w w w w w w w w w w w w w
correct answer Individuals who are under age 65 and have a disability
w w w w w w w w w w w
Which of the following is an example of a diagnostic category code? - correct answer I10
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(Diagnostic category codes contains three characters) w w w w w
A billing and coding specialist is determining third-party payer responsibilities for a 70-year-old patient who
w w w w w w w w w w w w w w w
has Medicare coverage. The patient's spouse has insurance with Blue Cross Blue Shield through their
w w w w w w w w w w w w w w w
, employer. Which of the following actions should the specialist take? - correct answer Establish coordination
w w w w w w w w w w w w w w w
of benefits
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When a patient has a condition that is both acute and chronic, how should it be coded? - correct answer Code
w w w w w w w w w w w w w w w w w w w w w
both the acute and chronic conditions, sequencing the acute condition first.
w w w w w w w w w w
When reviewing an established patient's insurance card, a billing and coding specialist notices a minor
w w w w w w w w w w w w w w w
change from the existing card on file. Which of the following actions should the specialist take? - correct
w w w w w w w w w w w w w w w w w w
answer Photocopy both sides of the new card w w w w w w w
On a remittance advice form, which of the following is responsible for writing off the difference between the
w w w w w w w w w w w w w w w w w w
amount billed and the amount allowed by the agreement? - correct answer Provider
w w w w w w w w w w w w
A provider's office receives a subpoena requesting medical documentation from a patient's medical record.
w w w w w w w w w w w w w w
After confirming the correct authorization, which of the following actions should a billing and coding
w w w w w w w w w w w w w w w
specialist take? - correct answer Send the medical information pertaining to the dates of service requested.
w w w w w w w w w w w w w w w
A billing and coding specialist is working on a claim in which reimbursement was reduced due to services
w w w w w w w w w w w w w w w w w w
being bundled. Which of the following types of modifiers should be assigned to indicate multiple procedures
w w w w w w w w w w w w w w w w
were performed to prevent bundling? - correct answer Category I modifier
w w w w w w w w w w
(category I modifier provides the means to report or indicate that a service or procedure that has been
w w w w w w w w w w w w w w w w w w
performed has been altered by some specific circumstance but not changed in its definition or code).
w w w w w w w w w w w w w w w
A billing and coding specialist is reviewing an encounter note that indicates a biopsy was performed. The
w w w w w w w w w w w w w w w w w
specialist requires which of the following additional details to fully code this procedure? - correct answer
w w w w w w w w w w w w w w w w
Benign vs. malignant status w w w
A billing and coding specialist is determining the level of service for an office visit for a new patient. Which of
w w w w w w w w w w w w w w w w w w w w w
the following codes represents a detailed history and detailed exam with moderate medical decision-
w w w w w w w w w w w w w
making? - correct answer 99204 w w w w
Which of the following is true regarding Medicaid eligibility? - correct answer Patient eligibility is determined
w w w w w w w w w w w w w w w w
at each visit.
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2025. (CORRECT ANSWERS)
A child is brought into a facility by their mother. The child is covered under both parents' insurance policies.
w w w w w w w w w w w w w w w w w w w
The child's father was born on 10/1/1980 and their mother was born on 10/2/1981. Which of the following
w w w w w w w w w w w w w w w w w w
statements is true regarding the primary policy holder for the child? - correct answer The father is the primary
w w w w w w w w w w w w w w w w w w
policy holder because his birthday falls first in the calendar year.
w w w w w w w w w w w
A billing and coding specialist is submitting a claim for a school-age child who was brought to the clinic by their
w w w w w w w w w w w w w w w w w w w w w
maternal grandmother. The child's parents are divorced and remarried, and the child's mother has legal
w w w w w w w w w w w w w w w
custody of the child. The specialist should recognize that the child's primary insurance coverage is provided
w w w w w w w w w w w w w w w w
through which of the following insured individuals? - correct answer Biologic mother
w w w w w w w w w w w
Which of the following is the purpose of running an insurance aging report each month? - correct answer To
w w w w w w w w w w w w w w w w w w w
determine which claims are outstanding from third-party payers
w w w w w w w
A billing and coding specialist observes a colleague perform an unethical act. Which of the following actions
w w w w w w w w w w w w w w w w w
should the specialist take? - correct answer Report the incident to a supervisor
w w w w w w w w w w w w
Which of the following statements is true regarding the release of patients records? - correct answer Patient
w w w w w w w w w w w w w w w w w
access to psychotherapy notes is restricted
w w w w w
,A billing and coding specialist is preparing a claim for a patient who had a procedure performed on their left
w w w w w w w w w w w w w w w w w w w w
index finger. Which of the following modifiers indicates the correct digit? - correct answer -F1
w w w w w w w w w w w w w w
-FA: used for left thumb
w w w w
-F6: used for right index finger
w w w w w
-F4: used for the left pinky
w w w w w
A billing and coding specialist is processing a claim for a patient who broke their arm while repairing cars at
w w w w w w w w w w w w w w w w w w w w
their workplace. There is no nerve damage, the arm is placed in a cast for 6 weeks, and the patient is cleared to
w w w w w w w w w w w w w w w w w w w w w w
return to work in 6 weeks. Which of the following types of workers' compensation applies to this patient? -
w w w w w w w w w w w w w w w w w w w w
correct answer Temporary disability w w w
Based on the CPT integumentary coding guidelines, Mohs micrographic surgery involves the provider filling
w w w w w w w w w w w w w w
which of the following roles? - correct answer Both the surgeon and pathologist
w w w w w w w w w w w w
A billing and coding specialist is preparing a claim for a provider. The operative note indicates the surgeon
w w w w w w w w w w w w w w w w w w
performed a CABG. The specialist should identify that CABG stands for which of the following? - correct
w w w w w w w w w w w w w w w w w
answer Coronary Artery Bypass Graft w w w w
A billing and coding specialist is arranging a payment plan with a patient who wants to leave postdated checks
w w w w w w w w w w w w w w w w w w
with the office. The patient proposes leaving one check postdated for 3 months, one for 4 months, and
w w w w w w w w w w w w w w w w w w w
another one for 5 months in the future. According to federal collection law, which of the following actions
w w w w w w w w w w w w w w w w w w
should the specialist take? - correct answer Notify the patient between 3 and 10 days prior to depositing each
w w w w w w w w w w w w w w w w w w w
check on the indicated date.w w w w
Which of the following qualifies a patient for eligibility under Medicare as the primary third-party payer? -
w w w w w w w w w w w w w w w w w
correct answer Individuals who are under age 65 and have a disability
w w w w w w w w w w w
Which of the following is an example of a diagnostic category code? - correct answer I10
w w w w w w w w w w w w w w w
(Diagnostic category codes contains three characters) w w w w w
A billing and coding specialist is determining third-party payer responsibilities for a 70-year-old patient who
w w w w w w w w w w w w w w w
has Medicare coverage. The patient's spouse has insurance with Blue Cross Blue Shield through their
w w w w w w w w w w w w w w w
, employer. Which of the following actions should the specialist take? - correct answer Establish coordination
w w w w w w w w w w w w w w w
of benefits
w
When a patient has a condition that is both acute and chronic, how should it be coded? - correct answer Code
w w w w w w w w w w w w w w w w w w w w w
both the acute and chronic conditions, sequencing the acute condition first.
w w w w w w w w w w
When reviewing an established patient's insurance card, a billing and coding specialist notices a minor
w w w w w w w w w w w w w w w
change from the existing card on file. Which of the following actions should the specialist take? - correct
w w w w w w w w w w w w w w w w w w
answer Photocopy both sides of the new card w w w w w w w
On a remittance advice form, which of the following is responsible for writing off the difference between the
w w w w w w w w w w w w w w w w w w
amount billed and the amount allowed by the agreement? - correct answer Provider
w w w w w w w w w w w w
A provider's office receives a subpoena requesting medical documentation from a patient's medical record.
w w w w w w w w w w w w w w
After confirming the correct authorization, which of the following actions should a billing and coding
w w w w w w w w w w w w w w w
specialist take? - correct answer Send the medical information pertaining to the dates of service requested.
w w w w w w w w w w w w w w w
A billing and coding specialist is working on a claim in which reimbursement was reduced due to services
w w w w w w w w w w w w w w w w w w
being bundled. Which of the following types of modifiers should be assigned to indicate multiple procedures
w w w w w w w w w w w w w w w w
were performed to prevent bundling? - correct answer Category I modifier
w w w w w w w w w w
(category I modifier provides the means to report or indicate that a service or procedure that has been
w w w w w w w w w w w w w w w w w w
performed has been altered by some specific circumstance but not changed in its definition or code).
w w w w w w w w w w w w w w w
A billing and coding specialist is reviewing an encounter note that indicates a biopsy was performed. The
w w w w w w w w w w w w w w w w w
specialist requires which of the following additional details to fully code this procedure? - correct answer
w w w w w w w w w w w w w w w w
Benign vs. malignant status w w w
A billing and coding specialist is determining the level of service for an office visit for a new patient. Which of
w w w w w w w w w w w w w w w w w w w w w
the following codes represents a detailed history and detailed exam with moderate medical decision-
w w w w w w w w w w w w w
making? - correct answer 99204 w w w w
Which of the following is true regarding Medicaid eligibility? - correct answer Patient eligibility is determined
w w w w w w w w w w w w w w w w
at each visit.
w w
