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NHA Billing and Coding Practice Test
Questions and Answers 2026 Latest Update
1. A billing and coding specialist discovers that one private payer
has not reimbursed the provider for any claims submitted in the
past year. Clean claims have been submitted to the payer and have
been acknowledged. Which of the following entities should the
specialist contact to report the payer's failure to submit timely
reimbursement? Ans: a. State Insurance Commissioner's office
1. Which of the following is an example of a diagnostic category
code? Ans: a. I10
1. The star symbol in the CPT coding manual is used to indicate
which of the following? Ans: a. Telemedicine
1. Which of the following is an advantage of electronic claim
submission? Ans: a. Claims are expedited
1. When should a billing and coding specialist initiate the
collection of the information needed to process a patient's
insurance claim form? Ans: a. When the patient contacts the
provider's office and schedules an appointment
1. A billing and coding specialist is reviewing modifier use with a
new employee. Which of the following scenarios warrants the use
of a modifier? Ans: a. Splinting of the fourth digit on the left foot
1. A billing and coding specialist is reviewing a provider's
documentation for a patient who underwent repair of multiple
© 2025 All rights reserved
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wounds to the face and trunk. The provider coded repair of all
wounds individually. The specialist should recognize that the
provider should have applied which of the following concepts to
the documentation of the repair for this patient's wounds? Ans: a.
Wounds should be grouped by anatomic site and coded in order of
complexity
1. Which of the following terms describe the removal of the eye,
adnexa, and bony structure? Ans: a. Exenteration
1. A billing and coding specialist is reviewing delinquent claims
and discovers that a third-party payer paid a claim but applied it
to the incorrect provider. The third-party payer will reimburse the
payment once the improperly paid funds are recouped. Which of
the following terms is used to describe this claim? Ans: a.
Suspended
1. For which of the following reasons should a claim be
resubmitted? Ans: a. The claim requires an attachment to support
medical necessity
1. A billing and coding specialist is preparing an account
receivable aging report. The specialist should expect the report to
include which of the following? Ans: a. Outstanding balances
organized by date
1. Which of the following pieces of guarantor information is
required when establishing a patient's financial record? Ans: a.
Phone number
1. Which of the following actions by a billing and coding specialist
ensures a patient's health information is protected? Ans: a. Using
data encryption software on office workstations
© 2025 All rights reserved
NHA Billing and Coding Practice Test
Questions and Answers 2026 Latest Update
1. A billing and coding specialist discovers that one private payer
has not reimbursed the provider for any claims submitted in the
past year. Clean claims have been submitted to the payer and have
been acknowledged. Which of the following entities should the
specialist contact to report the payer's failure to submit timely
reimbursement? Ans: a. State Insurance Commissioner's office
1. Which of the following is an example of a diagnostic category
code? Ans: a. I10
1. The star symbol in the CPT coding manual is used to indicate
which of the following? Ans: a. Telemedicine
1. Which of the following is an advantage of electronic claim
submission? Ans: a. Claims are expedited
1. When should a billing and coding specialist initiate the
collection of the information needed to process a patient's
insurance claim form? Ans: a. When the patient contacts the
provider's office and schedules an appointment
1. A billing and coding specialist is reviewing modifier use with a
new employee. Which of the following scenarios warrants the use
of a modifier? Ans: a. Splinting of the fourth digit on the left foot
1. A billing and coding specialist is reviewing a provider's
documentation for a patient who underwent repair of multiple
© 2025 All rights reserved
, 2 | Page
wounds to the face and trunk. The provider coded repair of all
wounds individually. The specialist should recognize that the
provider should have applied which of the following concepts to
the documentation of the repair for this patient's wounds? Ans: a.
Wounds should be grouped by anatomic site and coded in order of
complexity
1. Which of the following terms describe the removal of the eye,
adnexa, and bony structure? Ans: a. Exenteration
1. A billing and coding specialist is reviewing delinquent claims
and discovers that a third-party payer paid a claim but applied it
to the incorrect provider. The third-party payer will reimburse the
payment once the improperly paid funds are recouped. Which of
the following terms is used to describe this claim? Ans: a.
Suspended
1. For which of the following reasons should a claim be
resubmitted? Ans: a. The claim requires an attachment to support
medical necessity
1. A billing and coding specialist is preparing an account
receivable aging report. The specialist should expect the report to
include which of the following? Ans: a. Outstanding balances
organized by date
1. Which of the following pieces of guarantor information is
required when establishing a patient's financial record? Ans: a.
Phone number
1. Which of the following actions by a billing and coding specialist
ensures a patient's health information is protected? Ans: a. Using
data encryption software on office workstations
© 2025 All rights reserved
