MEDICAL CODING AND BILLING CERTIFICATION (MCBC) ACTUAL EXAM 2025
WITH CORRECT QUESTIONS WITH ANSWERS GRADED A+
1.Urine moves from the kidneys to the bladder through which of the bladder through which of the
following parts of the body? - ANSWER Ureter's
2. Threading a catheter with a balloon into a coronary artery and expanding it to repair arteries describes
which of the following procedures? - ANSWER Angioplasty
3. A patient's portion of the bill should be discussed with the patient before a procedure is performed for
which of the following reasons? - ANSWER To ensure the patient understands his portion of the bill
4.Which of the following actions by the billing and coding specialist prevent fraud? - ANSWER
Performing periodic audits
5. Which of the following information is required on a patient account record? - ANSWER Name and
address of guarantor
6. A claim is submitted with a transposed insurance member ID # and returned to the provider. Which of
the following describes the status that should be assigned to the claim by the carrier? - ANSWER Invalid
7. Which of the following should the billing and coding specialist complete to be reimbursed for the
provider's services? - ANSWER CMS-1500 claim form
8. Which of the following is a HIPAA compliance guideline affecting electronic health records? - ANSWER
The electronic transmission and code set standards require every provider to use the healthcare
transactions, code sets, and identifiers
9. Which of the following is the purpose of pre-certification? - ANSWER Verification of coverage
10. Which of the following should the billing and coding specialist include in an authorization to release
information? - ANSWER The entity to whom the information is to be released
,11. Which of the following actions should the billing and coding specialist take if he observes a colleague
in an unethical situation? - ANSWER Report the incident to a supervisor
12. When posting payment accurately, which of the following items should the billing and coding
specialist include? - ANSWER Patient Responsibilty
13. A dependent child whose parents both have insurance coverage comes to the clinic. The billing and
coding specialist uses the birthday rule to determine which insurance policy is primary. Which of the
following describes the birthday rule? - ANSWER The parent whose birth date comes first in the calendar
year
14. Which of the following statements is true regarding the release of patients records? - ANSWER
Patient access to psychotherapy notes may be restricted
15. A patients employer has not submitted a premium payment. Which of the following claim statuses
should the provider receive from the third-party payer? - ANSWER Denied
16. Which of the following do physicians use to electronically submit claims? - ANSWER Clearinghouse
17. When coding on the UB-04 form, the billing and coding specialist must sequence the diagnosis code
according to ICD guidelines. Which of the following is the first listed diagnoses code? - ANSWER Principal
diagnoses
18. A patient has AARP as secondary insurance. In which of the following blocks on the CMS-1500 claim
form should this information be entered? - ANSWER Block 9
19. According the HIPAA standards, which of the following identifies the rendering provider on the CMS-
1500 claim form in Block 24j? - ANSWER NPI (National Provider Identifier)
20. Which of the following is the function of the respiratory system? - ANSWER Oxygenating blood cells
, 21. Which of the following provisions ensures that an insured's benefits from all insurance companies do
no exceed 100% of allowable medical expenses? - ANSWER Coordination of benefits
23. Which if the following is the verbal or written agreement that gives approval to some action,
situation, or statement, and allows the release of patient information? - ANSWER Consent Agreement
24 A deductible of $100 is applied to a patients remittance advice. The provider requests the account
personnel to write it off. Which of the following terms describes this scenario? - ANSWER Fraud
25. A coroner's autopsy is comprised of which of the following examinations? - ANSWER Gross
examination
26. Which of the following is the advantage of electronic claim submission? - ANSWER Claims are
expedited
27. A patient presents to the provider with chest pain and shortness of breath. After an unexpected ECG
result, the provider calls a cardiologist and summarizes the patient's symptoms. What portion of HIPAA
allows the provider to speek to the cardiologist prior to obtaining the patients consent? - ANSWER Title ll
28. A physician ordered a comprehensive metabolic panel for a 70-year-old patient who has Medicare as
her primary insurance. Which of the following forms is requested so the patient knows she may be
responsible for payment? - ANSWER Advance Beneficiary Notice
29. Which of the following does a patient sign to allow payment of claims directly to the provider? -
ANSWER Assignment of benefits
30. All dependents 10 years of age or older are required to have which of the following for TRICARE? -
ANSWER Military Identification
31. Medigap coverage is offered to Medicare beneficiaries by which of the following? - ANSWER Private
third-party payers
WITH CORRECT QUESTIONS WITH ANSWERS GRADED A+
1.Urine moves from the kidneys to the bladder through which of the bladder through which of the
following parts of the body? - ANSWER Ureter's
2. Threading a catheter with a balloon into a coronary artery and expanding it to repair arteries describes
which of the following procedures? - ANSWER Angioplasty
3. A patient's portion of the bill should be discussed with the patient before a procedure is performed for
which of the following reasons? - ANSWER To ensure the patient understands his portion of the bill
4.Which of the following actions by the billing and coding specialist prevent fraud? - ANSWER
Performing periodic audits
5. Which of the following information is required on a patient account record? - ANSWER Name and
address of guarantor
6. A claim is submitted with a transposed insurance member ID # and returned to the provider. Which of
the following describes the status that should be assigned to the claim by the carrier? - ANSWER Invalid
7. Which of the following should the billing and coding specialist complete to be reimbursed for the
provider's services? - ANSWER CMS-1500 claim form
8. Which of the following is a HIPAA compliance guideline affecting electronic health records? - ANSWER
The electronic transmission and code set standards require every provider to use the healthcare
transactions, code sets, and identifiers
9. Which of the following is the purpose of pre-certification? - ANSWER Verification of coverage
10. Which of the following should the billing and coding specialist include in an authorization to release
information? - ANSWER The entity to whom the information is to be released
,11. Which of the following actions should the billing and coding specialist take if he observes a colleague
in an unethical situation? - ANSWER Report the incident to a supervisor
12. When posting payment accurately, which of the following items should the billing and coding
specialist include? - ANSWER Patient Responsibilty
13. A dependent child whose parents both have insurance coverage comes to the clinic. The billing and
coding specialist uses the birthday rule to determine which insurance policy is primary. Which of the
following describes the birthday rule? - ANSWER The parent whose birth date comes first in the calendar
year
14. Which of the following statements is true regarding the release of patients records? - ANSWER
Patient access to psychotherapy notes may be restricted
15. A patients employer has not submitted a premium payment. Which of the following claim statuses
should the provider receive from the third-party payer? - ANSWER Denied
16. Which of the following do physicians use to electronically submit claims? - ANSWER Clearinghouse
17. When coding on the UB-04 form, the billing and coding specialist must sequence the diagnosis code
according to ICD guidelines. Which of the following is the first listed diagnoses code? - ANSWER Principal
diagnoses
18. A patient has AARP as secondary insurance. In which of the following blocks on the CMS-1500 claim
form should this information be entered? - ANSWER Block 9
19. According the HIPAA standards, which of the following identifies the rendering provider on the CMS-
1500 claim form in Block 24j? - ANSWER NPI (National Provider Identifier)
20. Which of the following is the function of the respiratory system? - ANSWER Oxygenating blood cells
, 21. Which of the following provisions ensures that an insured's benefits from all insurance companies do
no exceed 100% of allowable medical expenses? - ANSWER Coordination of benefits
23. Which if the following is the verbal or written agreement that gives approval to some action,
situation, or statement, and allows the release of patient information? - ANSWER Consent Agreement
24 A deductible of $100 is applied to a patients remittance advice. The provider requests the account
personnel to write it off. Which of the following terms describes this scenario? - ANSWER Fraud
25. A coroner's autopsy is comprised of which of the following examinations? - ANSWER Gross
examination
26. Which of the following is the advantage of electronic claim submission? - ANSWER Claims are
expedited
27. A patient presents to the provider with chest pain and shortness of breath. After an unexpected ECG
result, the provider calls a cardiologist and summarizes the patient's symptoms. What portion of HIPAA
allows the provider to speek to the cardiologist prior to obtaining the patients consent? - ANSWER Title ll
28. A physician ordered a comprehensive metabolic panel for a 70-year-old patient who has Medicare as
her primary insurance. Which of the following forms is requested so the patient knows she may be
responsible for payment? - ANSWER Advance Beneficiary Notice
29. Which of the following does a patient sign to allow payment of claims directly to the provider? -
ANSWER Assignment of benefits
30. All dependents 10 years of age or older are required to have which of the following for TRICARE? -
ANSWER Military Identification
31. Medigap coverage is offered to Medicare beneficiaries by which of the following? - ANSWER Private
third-party payers
