Certified billing and Coding Specialist
Exam prep 2026
The insured may not necessarily be the patient seen for the medical service. - correct answersTrue
Personal insurance is usually less expensive than other health insurance. - correct answersFalse
Time limits stated in individual health insurance policies about an insurance company's obligation to pay
benefits are the same for all insurance companies. - correct answersFalse
There is standardization of format for the explanation of benefit document for all private insurance
carriers. - correct answersFalse
What organization publishes diagnostic and procedure coding competencies for outpatient services and
diagnostic coding and reporting requirements for physician billing? - correct answersAmerican Health
Information Management Association (AHIMA)
Medical etiquette refers to: - correct answersConsideration of others
CPT codes are assigned to which of these? - correct answersCoding procedures and services
Exceptions to the right of privacy rule include: - correct answersGunshot wound cases
A common format for medical record documentation is called: - correct answersSOAP
Most physician/patient contracts are: - correct answersImplied
An inventory of body systems for which the patient complains of signs and symptoms is called? - correct
answersROS
When coding a front torso burn, which percentage of body would be indicated? - correct answers18%
To which of the following would be assigned CPT code? - correct answersTonsillectomy
Urine moves through the kidneys to the bladder through the: - correct answersUreters
Which box of the CMS-1500 Form would be completed with codes for procedures, services or supplies? -
correct answersBox 24d
Which of these is considered PHI? - correct answersPhotographic images, even in profile
This means "Let the Master Answer"? - correct answersRespondeat Superior
Patient sees the physician for a regular office visit which is charged at $90. The allowable amount for the
patient's insurance company covers the office visit in full, with a $10 copay, and the patient has not met
the $125 deductible. How much does the patient owe? - correct answers$90
, Using SOAP notes, what would be found in the Assessment portion of the record? - correct
answersDiagnosis
If a Medicare patient wants a procedure that is a non-covered benefit, what form do they need to sign
that indicates they are aware it is not covered? - correct answersAdvanced Beneficiary Notice
Who is responsible for entering proper medical documentation to support reimbursement of
procedures and services? - correct answersClinician
The primary function of the spleen is: - correct answersProduction and removal of blood cells as part of
the immune system
The pre-established percentage of expenses paid by the patient, or another insurance carrier, after the
primary insurance has made payment, and the deductible is met:
Select one: - correct answersCoinsurance
What happens with information that is abstracted from the medical record? - correct answersCoded and
forwarded to the insurance
The significant reason for which a patient is admitted to the hospital is coded using the: - correct
answersPrincipal Diagnosis
Which of these is a common abbreviation for the test that assesses the electrical activity of the heart? -
correct answersECG
Confidential information about patients should never be discussed with: - correct answersFamily
Coworkers
Friends
Name the correct procedure for keeping an industrial patient's financial and health records when the
same physician is also seeing the patient as a private patient - correct answersSeparate financial and
health records must be used
Patient presents with abdominal pain. In what part of documentation would the duration and symptoms
be indicated? - correct answersHPI
The statutes for workers' compensation laws fall under: - correct answersFederal and state
compensation laws
Which of these is the result of a claim that is submitted electronically with an old insurance policy
number? - correct answersDenial
An NAS is a: - correct answersCertification from a military hospital stating that it cannot provide the
necessary care
A coding book that contains codes for products and supplies is: - correct answersHCPCS
Exam prep 2026
The insured may not necessarily be the patient seen for the medical service. - correct answersTrue
Personal insurance is usually less expensive than other health insurance. - correct answersFalse
Time limits stated in individual health insurance policies about an insurance company's obligation to pay
benefits are the same for all insurance companies. - correct answersFalse
There is standardization of format for the explanation of benefit document for all private insurance
carriers. - correct answersFalse
What organization publishes diagnostic and procedure coding competencies for outpatient services and
diagnostic coding and reporting requirements for physician billing? - correct answersAmerican Health
Information Management Association (AHIMA)
Medical etiquette refers to: - correct answersConsideration of others
CPT codes are assigned to which of these? - correct answersCoding procedures and services
Exceptions to the right of privacy rule include: - correct answersGunshot wound cases
A common format for medical record documentation is called: - correct answersSOAP
Most physician/patient contracts are: - correct answersImplied
An inventory of body systems for which the patient complains of signs and symptoms is called? - correct
answersROS
When coding a front torso burn, which percentage of body would be indicated? - correct answers18%
To which of the following would be assigned CPT code? - correct answersTonsillectomy
Urine moves through the kidneys to the bladder through the: - correct answersUreters
Which box of the CMS-1500 Form would be completed with codes for procedures, services or supplies? -
correct answersBox 24d
Which of these is considered PHI? - correct answersPhotographic images, even in profile
This means "Let the Master Answer"? - correct answersRespondeat Superior
Patient sees the physician for a regular office visit which is charged at $90. The allowable amount for the
patient's insurance company covers the office visit in full, with a $10 copay, and the patient has not met
the $125 deductible. How much does the patient owe? - correct answers$90
, Using SOAP notes, what would be found in the Assessment portion of the record? - correct
answersDiagnosis
If a Medicare patient wants a procedure that is a non-covered benefit, what form do they need to sign
that indicates they are aware it is not covered? - correct answersAdvanced Beneficiary Notice
Who is responsible for entering proper medical documentation to support reimbursement of
procedures and services? - correct answersClinician
The primary function of the spleen is: - correct answersProduction and removal of blood cells as part of
the immune system
The pre-established percentage of expenses paid by the patient, or another insurance carrier, after the
primary insurance has made payment, and the deductible is met:
Select one: - correct answersCoinsurance
What happens with information that is abstracted from the medical record? - correct answersCoded and
forwarded to the insurance
The significant reason for which a patient is admitted to the hospital is coded using the: - correct
answersPrincipal Diagnosis
Which of these is a common abbreviation for the test that assesses the electrical activity of the heart? -
correct answersECG
Confidential information about patients should never be discussed with: - correct answersFamily
Coworkers
Friends
Name the correct procedure for keeping an industrial patient's financial and health records when the
same physician is also seeing the patient as a private patient - correct answersSeparate financial and
health records must be used
Patient presents with abdominal pain. In what part of documentation would the duration and symptoms
be indicated? - correct answersHPI
The statutes for workers' compensation laws fall under: - correct answersFederal and state
compensation laws
Which of these is the result of a claim that is submitted electronically with an old insurance policy
number? - correct answersDenial
An NAS is a: - correct answersCertification from a military hospital stating that it cannot provide the
necessary care
A coding book that contains codes for products and supplies is: - correct answersHCPCS
