NHA MEDICAL CODING AND BILLING EXAM WITH ALL
CORRECT & VERIFIED ANSWERS (UPDATED TO PASS)
Place of Service Correct answer-Billing and coding specialists should first divide the E & M Code by
Privacy Officer Correct answer-Compliant with HIPPA the following position should be assigned in
each office
Principal Diagnosis Correct answer-Coding on the UB-04 Form, must sequence the diagnosis code.
Which is the first listed diagnosis?
Urethratresia Correct answer-Obstruction of the urethra is
UB04 Forms Correct answer-Ambulatory surgery centers, home health center, and hospice use
what form?
Encounter forms Correct answer-Form that contains of DOS, CPT, ICD codes, fees and copay
information is called
Add on Codes Correct answer-Anesthesia section of CPT manual which are considered qualifying
circumstances
Title 11 Correct answer-Patient presents with chest pain & shortness of breath with abnormal ECG
provider call a cardiologist. What portion of the HIPPA allows this
Code set standards pertain to all providers Correct answer-HIPPA compliance guideline affecting
EHR
Red Correct answer-Color formats on CMS 1500 form acceptable
Patient Ledger account Correct answer-Financial record generated by a provider office
Coding Compliance Plan Correct answer-Which of the following includes procedures and best
practices for correct coding
Sagittal Correct answer-Which of the following planes divides the body into left and right
Claim adjudication:( The term used in the industry to refer to the process of paying claims submitted
on denying them after comparing claims to the benefit or coverage requirements) Correct answer-
3rd Party payer validates a claim which takes place next
NCCI ( National Correct Coding Initiative) Correct answer-Developed to reduced Medicare Program
expenditure by detecting in appropriate codes & eliminating improper coding
0% Correct answer-Beneficiary of Medicaid/ Medicare crossover claim is responsible for the
percentage
Internal monitoring and auditing Correct answer-Which of the following steps would be part of a
physicians practice compliance program
, HIPPA Correct answer-Which of the following acts applies to the administrative simplification
guidelines?
Accounts recievable Correct answer-Patient charges that have not been paid will appear in which
of the following
adjudication Correct answer-Which of the following is considered the final determination of the
issues involving settlement of an insurance claim
A billing worksheet from the patient account Correct answer-A prospective billing account audit
prevents fraud by reviewing & comparing a completed claim for with which of the following
documents
Lymphatic system Correct answer-Which of the following parts of the body system regulates
immunity
Billing using 2- digit CPT Modifiers to indicate a procedure as preformed differs from its usual 5 digit
code Correct answer-Which of the following is allowed when billing procedural codes
Direct Data entry Correct answer-A biller will electronically submit a claim to the carrier via which
of the following?
A Providers office with fewer than 10 fulltime employees Correct answer-Medicare enforces
mandatory submission of electronic claims for most providers. Which of the providers is allowed to
submit paper claims to Medicare?
(RAC) Recovery audit Contractor Correct answer-Which of the following organizations identifies
improper payments made on CMS claims
Bone and bone marrow Correct answer-IF a patient has osteomyelitis he has problems with which
of the following areas?
Preauthorization form Correct answer-Which of the following is a requirement of some third-party
payers before a procedure is performed?
Precertification Correct answer-Ensure appropriate insurance coverage for an outpatient
procedure by first using the following process
History Correct answer-Key component if an evaluation and management service
837 Correct answer-Format used to submit electronic claims and 3rd Party payer
Office of the Inspector General (OIG) Correct answer-Entity that defines the essential element of a
comprehensive compliance program
National Coverage Determination Correct answer-Medicare Policy determines if a particular item
or service is covered
Left upper quadrant Correct answer-Location of the stomach, spleen, part of the pancreas and liver
18% Correct answer-Coding a front torso burn, what % should be used?
CORRECT & VERIFIED ANSWERS (UPDATED TO PASS)
Place of Service Correct answer-Billing and coding specialists should first divide the E & M Code by
Privacy Officer Correct answer-Compliant with HIPPA the following position should be assigned in
each office
Principal Diagnosis Correct answer-Coding on the UB-04 Form, must sequence the diagnosis code.
Which is the first listed diagnosis?
Urethratresia Correct answer-Obstruction of the urethra is
UB04 Forms Correct answer-Ambulatory surgery centers, home health center, and hospice use
what form?
Encounter forms Correct answer-Form that contains of DOS, CPT, ICD codes, fees and copay
information is called
Add on Codes Correct answer-Anesthesia section of CPT manual which are considered qualifying
circumstances
Title 11 Correct answer-Patient presents with chest pain & shortness of breath with abnormal ECG
provider call a cardiologist. What portion of the HIPPA allows this
Code set standards pertain to all providers Correct answer-HIPPA compliance guideline affecting
EHR
Red Correct answer-Color formats on CMS 1500 form acceptable
Patient Ledger account Correct answer-Financial record generated by a provider office
Coding Compliance Plan Correct answer-Which of the following includes procedures and best
practices for correct coding
Sagittal Correct answer-Which of the following planes divides the body into left and right
Claim adjudication:( The term used in the industry to refer to the process of paying claims submitted
on denying them after comparing claims to the benefit or coverage requirements) Correct answer-
3rd Party payer validates a claim which takes place next
NCCI ( National Correct Coding Initiative) Correct answer-Developed to reduced Medicare Program
expenditure by detecting in appropriate codes & eliminating improper coding
0% Correct answer-Beneficiary of Medicaid/ Medicare crossover claim is responsible for the
percentage
Internal monitoring and auditing Correct answer-Which of the following steps would be part of a
physicians practice compliance program
, HIPPA Correct answer-Which of the following acts applies to the administrative simplification
guidelines?
Accounts recievable Correct answer-Patient charges that have not been paid will appear in which
of the following
adjudication Correct answer-Which of the following is considered the final determination of the
issues involving settlement of an insurance claim
A billing worksheet from the patient account Correct answer-A prospective billing account audit
prevents fraud by reviewing & comparing a completed claim for with which of the following
documents
Lymphatic system Correct answer-Which of the following parts of the body system regulates
immunity
Billing using 2- digit CPT Modifiers to indicate a procedure as preformed differs from its usual 5 digit
code Correct answer-Which of the following is allowed when billing procedural codes
Direct Data entry Correct answer-A biller will electronically submit a claim to the carrier via which
of the following?
A Providers office with fewer than 10 fulltime employees Correct answer-Medicare enforces
mandatory submission of electronic claims for most providers. Which of the providers is allowed to
submit paper claims to Medicare?
(RAC) Recovery audit Contractor Correct answer-Which of the following organizations identifies
improper payments made on CMS claims
Bone and bone marrow Correct answer-IF a patient has osteomyelitis he has problems with which
of the following areas?
Preauthorization form Correct answer-Which of the following is a requirement of some third-party
payers before a procedure is performed?
Precertification Correct answer-Ensure appropriate insurance coverage for an outpatient
procedure by first using the following process
History Correct answer-Key component if an evaluation and management service
837 Correct answer-Format used to submit electronic claims and 3rd Party payer
Office of the Inspector General (OIG) Correct answer-Entity that defines the essential element of a
comprehensive compliance program
National Coverage Determination Correct answer-Medicare Policy determines if a particular item
or service is covered
Left upper quadrant Correct answer-Location of the stomach, spleen, part of the pancreas and liver
18% Correct answer-Coding a front torso burn, what % should be used?
