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NHA Certified Billing and Coding Specialist (CBCS)
Exam Study Set 2026/2027 ||Verified Exam!!||Verified
Questions with Detailed Coding Explanations
1. A billing and coding specialist is reviewing a provider's
documentation for a patient who underwent repair of
multiple 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? - Answer-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? - Answer-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? - Answer-a. Suspended
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1. For which of the following reasons should a claim be
resubmitted? - Answer-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? - Answer-a.
Outstanding balances organized by date
1. Which of the following pieces of guarantor information is
required when establishing a patient's financial record? -
Answer-a. Phone number
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? - Answer-a. State Insurance
Commissioner's office
1. Which of the following is an example of a diagnostic
category code? - Answer-a. I10
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1. The star symbol in the CPT coding manual is used to
indicate which of the following? - Answer-a. Telemedicine
1. Which of the following is an advantage of electronic
claim submission? - Answer-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? - Answer-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? - Answer-a. Splinting of the
fourth digit on the left foot
1. Which of the following actions by a billing and coding
specialist ensures a patient's health information is
protected? - Answer-a. Using data encryption software on
office workstations
NHA Certified Billing and Coding Specialist (CBCS)
Exam Study Set 2026/2027 ||Verified Exam!!||Verified
Questions with Detailed Coding Explanations
1. A billing and coding specialist is reviewing a provider's
documentation for a patient who underwent repair of
multiple 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? - Answer-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? - Answer-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? - Answer-a. Suspended
,2|Page
1. For which of the following reasons should a claim be
resubmitted? - Answer-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? - Answer-a.
Outstanding balances organized by date
1. Which of the following pieces of guarantor information is
required when establishing a patient's financial record? -
Answer-a. Phone number
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? - Answer-a. State Insurance
Commissioner's office
1. Which of the following is an example of a diagnostic
category code? - Answer-a. I10
, 3|Page
1. The star symbol in the CPT coding manual is used to
indicate which of the following? - Answer-a. Telemedicine
1. Which of the following is an advantage of electronic
claim submission? - Answer-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? - Answer-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? - Answer-a. Splinting of the
fourth digit on the left foot
1. Which of the following actions by a billing and coding
specialist ensures a patient's health information is
protected? - Answer-a. Using data encryption software on
office workstations
