NHA CBCS Practice Questions (Set 2): With Answers

NHA 2024-2025 CBCS Practice Questions (Set 2): With Answers

1. Which of the following is considered Protected Health Patient's email address
Information (PHI) under the Health Insurance Porta-
bility and Accountability Act (HIPPA)?

2. Emily, a 45-year old patient, has recently been di- Submit the claim to the
agnosed with a chronic condition that requires on- primary insurance first,
going treatment. Her primary insurance is through then the secondary insur-
her employer, but she also has a secondary insur- ance
ance through her spouse's employer. When submit-
ting claims for Emily's treatment, what is the correct
order of billing to ensure proper coordination of ben-
efits?

3. Dr. Smith preformed a minor surgical procedure on 24- procedures per-

John Doe at an outpatient surgery center. Which place formed in an ambulatory
of service code should be used for this procedure? surgery center ASC)

4. Sarah, a medical billing specialist, is reviewing the ac- Obtain the neces-
count of a patient named John Doe. She notices that sary pre-authorization and

the insurance company has a lack of pre-authorization then resubmit the claim
for a specific procedure. What is the best course of
action for Sarah to take to resolve this issue?

5. Dr. Smith is submitting a CMS-1500 claim form for - Box 24-
patient named John Doe, who received outpatient Service Line
Information
services covered by medicare. 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


, NHA 2024-2025 CBCS Practice Questions (Set 2): With Answers

Box1-InsuranceType
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, NHA 2024-2025 CBCS Practice Questions (Set 2): With Answers

6. Whichofthefollowingisaprimarypurposeofinternal Toidentifythecorrectcod-
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audits in the context of medical billing and coding?
s s ing errors before claim
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submissions s




7. Dr. Smith's office received a request from John Does
s s s s s s s s Provideonlythe mini- s s s




insurance company for his medical records to process mum necessary informa-
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a claim. According to HIPPA regulations, what is the
s s tion required to process s s s s s s s s s




most appropriate action for Dr. Smith's office to take? theclaim
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8. When coding for Obstetrics, which of the following
s Z34.00: Routine prenatal
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codes is used to indicate a routine prenatal visit with no fornormal first pregnancy
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complications?
s no complications s s




- Z34.00: Routine prenatal for normal first pregnancy
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no complications
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- O09.89: Supervision of high risk pregnancy s s s s s




- Z33.1: Encounter for pregnancy test s s s s




- O10.11: Pre-existing hypertension complicating s s s




pregnancy
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9. Sarah, a patient. has recently filled for bankruptcy. As
s s s s s s s s Ceaseallcollectionactiv-
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amedical billing specialist, whatis the appropriate ac- itiesandnotifythebank-
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tion to take regarding her outstanding medical bills?
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ance s s s s
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eligibility for s s




10. When coding for telemedicine services, which modi-
s
a patient s s s s s
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fier should be appended to indicate the service was
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named s s s s s s
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provided via Telehealth?
s s John who
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has a s s




11. When a patient has multiple insurance plans, which
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insurance plan is typically considered the primary in-
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surance?
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12. Sarah, a medical billing specialist, is verifying insur-
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, NHA 2024-2025 CBCS Practice Questions (Set 2): With Answers

ruptcy court Modifier 95
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Theinsuranceplanpro- vided by the patients em- ployer
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