NHA BILLING CODING CORRECT FINAL ANSWERS
AND QUESTIONS SET A+
✔✔1. A child is brought into a facility by their mother. The child is cover under both
parents' insurance policies. The child's father was born on 10/1/1980 and their mother
was born on 10/2/1921. Which of the following statements is true regarding the primary
policy holder for the child? - ✔✔a. The father is the primary policy holder because his
birthday falls first in the calendar year
✔✔1. A billing and coding specialist is processing a claim for a patient who broke their
arm while repairing cars at their workplace. There is no nerve damage, the arm is
placed in a cast for 6 weeks, and the patient is cleared to return to work in 6 weeks.
Which of the following types of workers' compensation applies to this patient? - ✔✔a.
Temporary disability
✔✔1. Which of the following information is required on a patient account required? -
✔✔a. Name and address of guarantor
✔✔1. A billing and coding specialist is reviewing a delinquent claim. Which of the
following actions should the specialist take first? - ✔✔a. Verify the age of the account
✔✔1. A patient presents to a provider's office with difficulty speaking, facial drooping,
and an inability to close their left eye. They are diagnosed with Bell's palsy. A billing and
coding specialist should report which of the following ICD-10-CM codes? - ✔✔a. G51.0
✔✔1. A patient has a breast biopsy with the placement of a clip. After the biopsy is
determined to be malignant, the patient elects for a mastectomy during the global period
of the biopsy. Which of the following modifiers should a billing and coding specialist use
to report the mastectomy? - ✔✔-58
✔✔1. A billing and coding specialist is reviewing a report from the clearinghouse after
submitting electronic claims and notices that one claim was rejected due to missing
, demographic information. Which of the following actions should the specialist take? -
✔✔a. Resubmit an updated claim
✔✔1. A billing and coding specialist is reviewing a remittance advice from Medicare and
notice that the amount paid for a procedure is less than the contracted amount. Which
of the following is potential reason for the reduced amount of payment? - ✔✔a. The
claim indicated an incorrect place of service
✔✔1. A billing and coding specialist is collecting demographic information from a
patient. Which of the following pieces of information should the specialist expect the
Medicaid eligibility verification system (MEVS) to provide? - ✔✔a. Dates of coverage
✔✔1. Which of the following is the purpose of an internal review in a provider's office? -
✔✔a. To verify that the medical records and the billing record match
✔✔1. A claim is submitted with a transposed insurance member ID number and
returned to the provider. Which of the following describes the status that will be
assigned to the claim by the third-party payer? - ✔✔a. Invalid
✔✔1. A billing and coding specialist is reviewing a claim for a patient who presented to
the provider's office for an upper respiratory infection. During the encounter, the patient
also received the influenza vaccine. Which of the following modifiers should be attached
to the Evaluation and Management (E/M) code? - ✔✔-25
✔✔1. Which of the following is a valid ICD-10-CM principle? - ✔✔a. Code signs and
symptoms in the absence of a definite diagnosis
✔✔1. Which of the following entities are required to follow HIPAA rules and regulations?
- ✔✔a. Clearinghouses, health insurance companies, and billing services
✔✔1. Which of the following information is correct regarding code symbols in the CPT
manual? - ✔✔a. A product pending FDA approval is indicated by a lightning bolt symbol
✔✔1. A billing and coding specialist should add modifier -50 to a code when reporting
which of the following? - ✔✔a. A bilateral procedure
✔✔1. An explanation of benefits states the amount billed was $60, and the patient is
required to pay a $20 copayment. Which of the following describes the insurance check
amount to be posted? - ✔✔$40
✔✔1. A billing and coding specialist is reviewing a remittance advice and encounters a
denial of payment for a CPT code 44950 (appendectomy). The specialist discovers the
ICD-10-CM code assigned to the claim was J32.1 (chronic frontal sinusitis). Which of
AND QUESTIONS SET A+
✔✔1. A child is brought into a facility by their mother. The child is cover under both
parents' insurance policies. The child's father was born on 10/1/1980 and their mother
was born on 10/2/1921. Which of the following statements is true regarding the primary
policy holder for the child? - ✔✔a. The father is the primary policy holder because his
birthday falls first in the calendar year
✔✔1. A billing and coding specialist is processing a claim for a patient who broke their
arm while repairing cars at their workplace. There is no nerve damage, the arm is
placed in a cast for 6 weeks, and the patient is cleared to return to work in 6 weeks.
Which of the following types of workers' compensation applies to this patient? - ✔✔a.
Temporary disability
✔✔1. Which of the following information is required on a patient account required? -
✔✔a. Name and address of guarantor
✔✔1. A billing and coding specialist is reviewing a delinquent claim. Which of the
following actions should the specialist take first? - ✔✔a. Verify the age of the account
✔✔1. A patient presents to a provider's office with difficulty speaking, facial drooping,
and an inability to close their left eye. They are diagnosed with Bell's palsy. A billing and
coding specialist should report which of the following ICD-10-CM codes? - ✔✔a. G51.0
✔✔1. A patient has a breast biopsy with the placement of a clip. After the biopsy is
determined to be malignant, the patient elects for a mastectomy during the global period
of the biopsy. Which of the following modifiers should a billing and coding specialist use
to report the mastectomy? - ✔✔-58
✔✔1. A billing and coding specialist is reviewing a report from the clearinghouse after
submitting electronic claims and notices that one claim was rejected due to missing
, demographic information. Which of the following actions should the specialist take? -
✔✔a. Resubmit an updated claim
✔✔1. A billing and coding specialist is reviewing a remittance advice from Medicare and
notice that the amount paid for a procedure is less than the contracted amount. Which
of the following is potential reason for the reduced amount of payment? - ✔✔a. The
claim indicated an incorrect place of service
✔✔1. A billing and coding specialist is collecting demographic information from a
patient. Which of the following pieces of information should the specialist expect the
Medicaid eligibility verification system (MEVS) to provide? - ✔✔a. Dates of coverage
✔✔1. Which of the following is the purpose of an internal review in a provider's office? -
✔✔a. To verify that the medical records and the billing record match
✔✔1. A claim is submitted with a transposed insurance member ID number and
returned to the provider. Which of the following describes the status that will be
assigned to the claim by the third-party payer? - ✔✔a. Invalid
✔✔1. A billing and coding specialist is reviewing a claim for a patient who presented to
the provider's office for an upper respiratory infection. During the encounter, the patient
also received the influenza vaccine. Which of the following modifiers should be attached
to the Evaluation and Management (E/M) code? - ✔✔-25
✔✔1. Which of the following is a valid ICD-10-CM principle? - ✔✔a. Code signs and
symptoms in the absence of a definite diagnosis
✔✔1. Which of the following entities are required to follow HIPAA rules and regulations?
- ✔✔a. Clearinghouses, health insurance companies, and billing services
✔✔1. Which of the following information is correct regarding code symbols in the CPT
manual? - ✔✔a. A product pending FDA approval is indicated by a lightning bolt symbol
✔✔1. A billing and coding specialist should add modifier -50 to a code when reporting
which of the following? - ✔✔a. A bilateral procedure
✔✔1. An explanation of benefits states the amount billed was $60, and the patient is
required to pay a $20 copayment. Which of the following describes the insurance check
amount to be posted? - ✔✔$40
✔✔1. A billing and coding specialist is reviewing a remittance advice and encounters a
denial of payment for a CPT code 44950 (appendectomy). The specialist discovers the
ICD-10-CM code assigned to the claim was J32.1 (chronic frontal sinusitis). Which of
