EXAM 2025/2026 QUESTIONS
WITH CORRECT ANSWER
Which of the following blocks should the billing and coding
specialist complete the CMS 1500 claims form for procedure,
services or supplies?
-Block 12
-Block 2
-Block 24D
-Block 24J - Correct Answer>>Block 24D
-Block 12 (patient's authorization block
-Block 2 ( patient's name)
-Block 24J ( for the rendering provider)
Which of the following blocks requires the patient's
authorization to release medical information to process a
claim?
Block 12
Block 13
Block 27
Block 31 - Correct Answer>>Block 12
- Block 13 patient authorization for benefits required for third
party payer
- Block 27 accepting assignment of benefits
- Block 31 (treating physician)
,Which of the following steps would be part of a physician's
practice compliance program?
-HIPAA compliance audit
-Physician recruitment
-Internal monitoring and auditing
-Notice of privacy practice - Correct Answer>>Internal
monitoring and auditing
Behavior plays an important part of being a team player in a
medical practice. Which of the following is an appropriate
action for the CBCS to take?
-Reprimanding another staff member during a team meeting
for displaying a bad attitude toward a patient
-Looking in the medical record of a friend who receives services
at the office
-Communicating with the front desk staff during a team
meeting about missing information in patient files
-Questioning the nurse about the provider documentation in
the medical record - Correct Answer>>Communicating with the
front desk staff during a team meeting about missing
information in patient files
Which of the following acts applies to the administrative
simplification guideline?
-HIPAA
-Deficit reduction act of 2005
-The patient protection and affordable care act 2009
-National correct coding initiative of 1995 - Correct
Answer>>HIPAA
,Which of the following is an example of a violation of an adult
patient's confidentiality?
-While reviewing a claim, the CBCS reads the diagnosis before
realizing that the patient is a neighbor
-A CBCS queries the physician about a diagnosis in a patient's
medical record
-The physician uses his home phone to discuss patient care with
the nursing staff
-Patient information was disclosed to the patient's parents
without consent - Correct Answer>>Patient information was
disclosed to the patient's parents without consent
Which of the following is the purpose of running an aging
report each month?
-If indicates the balances the patients owe the provider
-It indicates which patients have upcoming or missed
appointment
-It indicates which claims are outstanding
-It indicates what the insurance company has paid for the
provider's services to a patient. - Correct Answer>>It indicates
which claims are outstanding
Which of the following describes the status of a claim that does
not include the required preauthorization for a service?
-Delinquent (overdue)
-Denied
-Suspended
, -Adjudicated (claim still being processed) - Correct
Answer>>Denied
-Delinquent (overdue)
-Adjudicated (claim still being processed)
Which of the following actions should the CBCS take to prevent
fraud and abuse in the medical office?
-Serviced procedure preauthorization
-Internal monitoring and auditing
-Utilization review
-Correct coding initiative - Correct Answer>>Internal monitoring
and auditing
In an outpatient setting, which of the following forms is used as
a financial report of all services provided to patients?
-Encounter form
-Patient account record
-CMS-1500 claim form
-Accounts receivable journal - Correct Answer>>Patient account
record (patient ledger, all transactions between patient and the
practice)
-Accounts receivable journal (Day sheet = chronological
summary of all transaction on a specific day)
Patient charges that have not been paid will appear in which of
the following?
-Accounts receivable
-Accounts payable
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