1 | Page
NHA 2024-2025 CBCS Practice Questions
(Set 2): Questions and Answers 2026 Latest
Update
Which of the following is considered Protected Health Information
(PHI) under the Health Insurance Portability and Accountability Act
(HIPPA)? Ans: Patient's email address
Emily, a 45-year old patient, has recently been diagnosed with a
chronic condition that requires ongoing treatment. Her primary
insurance is through her employer, but she also has a secondary
insurance through her spouse's employer. When submitting claims
for Emily's treatment, what is the correct order of billing to ensure
proper coordination of benefits? Ans: Submit the claim to the
primary insurance first, then the secondary insurance
Dr. Smith preformed a minor surgical procedure on John Doe at an
outpatient surgery center. Which place of service code should be
used for this procedure? Ans: 24- procedures performed in an
ambulatory surgery center ASC)
Sarah, a medical billing specialist, is reviewing the account of a
patient named John Doe. She notices that the insurance company
has a lack of pre-authorization for a specific procedure. What is
the best course of action for Sarah to take to resolve this issue?
Ans: Obtain the necessary pre-authorization and then resubmit
the claim
Dr. Smith is submitting a CMS-1500 claim form for patient named
John Doe, who received outpatient services covered by medicare.
© 2025 All rights reserved
, 2 | Page
Which section of the CMS-1500 form should Dr. Smith complete to
indicate the type of insurance plan covering John Doe?
- Box 1a- insured's ID Number
- Box 11- Insured Policy Group or FECA number
- Box 1- Insurance Type
- Box 24- Service Line Information Ans: Box 1- Insurance Type
Which of the following is a primary purpose of internal audits in
the context of medical billing and coding? Ans: To identify the
correct coding errors before claim submissions
Dr. Smith's office received a request from John Does insurance
company for his medical records to process a claim. According to
HIPPA regulations, what is the most appropriate action for Dr.
Smith's office to take? Ans: Provide only the minimum necessary
information required to process the claim
When coding for Obstetrics, which of the following codes is used
to indicate a routine prenatal visit with no complications?
- Z34.00: Routine prenatal for normal first pregnancy no
complications
- O09.89: Supervision of high risk pregnancy
- Z33.1: Encounter for pregnancy test
© 2025 All rights reserved
, 3 | Page
- O10.11: Pre-existing hypertension complicating pregnancy Ans:
Z34.00: Routine prenatal for normal first pregnancy no
complications
Sarah, a patient. has recently filled for bankruptcy. As a medical
billing specialist, what is the appropriate action to take regarding
her outstanding medical bills? Ans: Cease all collection activities
and notify the bankruptcy court
When coding for telemedicine services, which modifier should be
appended to indicate the service was provided via Telehealth? Ans:
Modifier 95
When a patient has multiple insurance plans, which insurance plan
is typically considered the primary insurance? Ans: The insurance
plan provided by the patients employer
Sarah, a medical billing specialist, is verifying insurance eligibility
for a patient named John who has a commercial insurance plan.
Which of the following is a requirement she must fulfill to ensure
that John's insurance eligibility is verified correctly? Ans: Confirm
the patient's policy number and group number
Which of the following is the most crucial step in ensuring all
applicable charges are captured for optimal reimbursement? Ans:
Reviewing patient encounter forms and progress notes
Sarah, a patient with a PPO insurance plan, needs to undergo a
specialized surgery. Her preferred surgeon is out-of-network.
Which of the following steps should Sarah take to understand her
out-of-network coverage and potential costs? Ans: Contact her
insurance company to verify out-of-network benefits and obtain
pre-authorization
© 2025 All rights reserved
NHA 2024-2025 CBCS Practice Questions
(Set 2): Questions and Answers 2026 Latest
Update
Which of the following is considered Protected Health Information
(PHI) under the Health Insurance Portability and Accountability Act
(HIPPA)? Ans: Patient's email address
Emily, a 45-year old patient, has recently been diagnosed with a
chronic condition that requires ongoing treatment. Her primary
insurance is through her employer, but she also has a secondary
insurance through her spouse's employer. When submitting claims
for Emily's treatment, what is the correct order of billing to ensure
proper coordination of benefits? Ans: Submit the claim to the
primary insurance first, then the secondary insurance
Dr. Smith preformed a minor surgical procedure on John Doe at an
outpatient surgery center. Which place of service code should be
used for this procedure? Ans: 24- procedures performed in an
ambulatory surgery center ASC)
Sarah, a medical billing specialist, is reviewing the account of a
patient named John Doe. She notices that the insurance company
has a lack of pre-authorization for a specific procedure. What is
the best course of action for Sarah to take to resolve this issue?
Ans: Obtain the necessary pre-authorization and then resubmit
the claim
Dr. Smith is submitting a CMS-1500 claim form for patient named
John Doe, who received outpatient services covered by medicare.
© 2025 All rights reserved
, 2 | Page
Which section of the CMS-1500 form should Dr. Smith complete to
indicate the type of insurance plan covering John Doe?
- Box 1a- insured's ID Number
- Box 11- Insured Policy Group or FECA number
- Box 1- Insurance Type
- Box 24- Service Line Information Ans: Box 1- Insurance Type
Which of the following is a primary purpose of internal audits in
the context of medical billing and coding? Ans: To identify the
correct coding errors before claim submissions
Dr. Smith's office received a request from John Does insurance
company for his medical records to process a claim. According to
HIPPA regulations, what is the most appropriate action for Dr.
Smith's office to take? Ans: Provide only the minimum necessary
information required to process the claim
When coding for Obstetrics, which of the following codes is used
to indicate a routine prenatal visit with no complications?
- Z34.00: Routine prenatal for normal first pregnancy no
complications
- O09.89: Supervision of high risk pregnancy
- Z33.1: Encounter for pregnancy test
© 2025 All rights reserved
, 3 | Page
- O10.11: Pre-existing hypertension complicating pregnancy Ans:
Z34.00: Routine prenatal for normal first pregnancy no
complications
Sarah, a patient. has recently filled for bankruptcy. As a medical
billing specialist, what is the appropriate action to take regarding
her outstanding medical bills? Ans: Cease all collection activities
and notify the bankruptcy court
When coding for telemedicine services, which modifier should be
appended to indicate the service was provided via Telehealth? Ans:
Modifier 95
When a patient has multiple insurance plans, which insurance plan
is typically considered the primary insurance? Ans: The insurance
plan provided by the patients employer
Sarah, a medical billing specialist, is verifying insurance eligibility
for a patient named John who has a commercial insurance plan.
Which of the following is a requirement she must fulfill to ensure
that John's insurance eligibility is verified correctly? Ans: Confirm
the patient's policy number and group number
Which of the following is the most crucial step in ensuring all
applicable charges are captured for optimal reimbursement? Ans:
Reviewing patient encounter forms and progress notes
Sarah, a patient with a PPO insurance plan, needs to undergo a
specialized surgery. Her preferred surgeon is out-of-network.
Which of the following steps should Sarah take to understand her
out-of-network coverage and potential costs? Ans: Contact her
insurance company to verify out-of-network benefits and obtain
pre-authorization
© 2025 All rights reserved
