NHA MEDICAL CODING AND BILLING FINAL
PAPER EXAM REVIEW TESTED QUESTIONS
2026 100% CORRECT
⫸ 1. Which of the following is an example of a diagnostic category
code? Answer: a. I10
⫸ 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. 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
⫸ 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. 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
⫸ 1. A billing and coding specialist is preparing an appeal letter in
response to a denial by a third-party payer for lack of medical
necessity. Which of the following should the specialist include with
the letter to indicate medical necessity? Answer: a. Medical record
documentation
⫸ 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? Answer: 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? Answer: a.
Temporary disability
⫸ 1. Which of the following information is required on a patient
account required? Answer: a. Name and address of guarantor
PAPER EXAM REVIEW TESTED QUESTIONS
2026 100% CORRECT
⫸ 1. Which of the following is an example of a diagnostic category
code? Answer: a. I10
⫸ 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. 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
⫸ 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. 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
⫸ 1. A billing and coding specialist is preparing an appeal letter in
response to a denial by a third-party payer for lack of medical
necessity. Which of the following should the specialist include with
the letter to indicate medical necessity? Answer: a. Medical record
documentation
⫸ 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? Answer: 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? Answer: a.
Temporary disability
⫸ 1. Which of the following information is required on a patient
account required? Answer: a. Name and address of guarantor
