NHA - Certified
Billing and Coding
Specialist (CBCS)
Study Guide
Reinstated or recycled code - ✔✔- ACTUAL ANSWER- The symbol "O" in the
Current Procedural Terminology reference is used to indicate what?
Add-on codes - ✔✔- ACTUAL ANSWER- In the anesthesia section of the CPT
manual, what are considered qualifying circumstances?
12 - ✔✔- ACTUAL ANSWER- As of April 1, 2014 what is the maximum number
of diagnoses that can be reported on the CMS-1500 claim form before a further
claim is required?
Operative report - ✔✔- ACTUAL ANSWER- What is considered proper
supportive documentation for reporting CPT and ICD codes for surgical
procedures?
Verify the age of the account - ✔✔- ACTUAL ANSWER- What action should be
taken first when reviewing a delinquent claim?
Block 24D contains the diagnosis code - ✔✔- ACTUAL ANSWER- A claim can
be denied or rejected for which of the following reasons?
, Gross Examination - ✔✔- ACTUAL ANSWER- A coroner's autopsy is comprised
of what examinations?
Private third-party payers - ✔✔- ACTUAL ANSWER- Medigap coverage is
offered to Medicare beneficiaries by whom?
Part C - ✔✔- ACTUAL ANSWER- What part of Medicare covers prescriptions?
Sagittal - ✔✔- ACTUAL ANSWER- What plane divides the body into left and
right?
Guidelines prior to each section - ✔✔- ACTUAL ANSWER- Where can unlisted
codes be found in the CPT manual?
UB-04 Claim Form - ✔✔- ACTUAL ANSWER- Ambulatory surgery centers,
home health care, and hospice organizations use which form to submit claims?
Red - ✔✔- ACTUAL ANSWER- What color format is acceptable on the
CMS-1500 claim form?
Patient - ✔✔- ACTUAL ANSWER- Who is responsible to pay the deductible?
Medicaid - ✔✔- ACTUAL ANSWER- A patient's health plan is referred to as the
"payer of last resort." What is the name of that health plan?
Providers explain medical or diagnostic procedures, surgical interventions, and
the benefits and risks involved, giving patients an opportunity to ask questions
before medical intervention is provided. - ✔✔- ACTUAL ANSWER- Informed
Consent
A patient presents for treatment, such as extending an arm to allow a
venipuncture to be performed. - ✔✔- ACTUAL ANSWER- Implied Consent
Agency that converts claims into standardized electronic format, looks for errors,
and formats them according to HIPAA and insurance standards. - ✔✔- ACTUAL
ANSWER- Clearinghouse
Billing and Coding
Specialist (CBCS)
Study Guide
Reinstated or recycled code - ✔✔- ACTUAL ANSWER- The symbol "O" in the
Current Procedural Terminology reference is used to indicate what?
Add-on codes - ✔✔- ACTUAL ANSWER- In the anesthesia section of the CPT
manual, what are considered qualifying circumstances?
12 - ✔✔- ACTUAL ANSWER- As of April 1, 2014 what is the maximum number
of diagnoses that can be reported on the CMS-1500 claim form before a further
claim is required?
Operative report - ✔✔- ACTUAL ANSWER- What is considered proper
supportive documentation for reporting CPT and ICD codes for surgical
procedures?
Verify the age of the account - ✔✔- ACTUAL ANSWER- What action should be
taken first when reviewing a delinquent claim?
Block 24D contains the diagnosis code - ✔✔- ACTUAL ANSWER- A claim can
be denied or rejected for which of the following reasons?
, Gross Examination - ✔✔- ACTUAL ANSWER- A coroner's autopsy is comprised
of what examinations?
Private third-party payers - ✔✔- ACTUAL ANSWER- Medigap coverage is
offered to Medicare beneficiaries by whom?
Part C - ✔✔- ACTUAL ANSWER- What part of Medicare covers prescriptions?
Sagittal - ✔✔- ACTUAL ANSWER- What plane divides the body into left and
right?
Guidelines prior to each section - ✔✔- ACTUAL ANSWER- Where can unlisted
codes be found in the CPT manual?
UB-04 Claim Form - ✔✔- ACTUAL ANSWER- Ambulatory surgery centers,
home health care, and hospice organizations use which form to submit claims?
Red - ✔✔- ACTUAL ANSWER- What color format is acceptable on the
CMS-1500 claim form?
Patient - ✔✔- ACTUAL ANSWER- Who is responsible to pay the deductible?
Medicaid - ✔✔- ACTUAL ANSWER- A patient's health plan is referred to as the
"payer of last resort." What is the name of that health plan?
Providers explain medical or diagnostic procedures, surgical interventions, and
the benefits and risks involved, giving patients an opportunity to ask questions
before medical intervention is provided. - ✔✔- ACTUAL ANSWER- Informed
Consent
A patient presents for treatment, such as extending an arm to allow a
venipuncture to be performed. - ✔✔- ACTUAL ANSWER- Implied Consent
Agency that converts claims into standardized electronic format, looks for errors,
and formats them according to HIPAA and insurance standards. - ✔✔- ACTUAL
ANSWER- Clearinghouse
