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NHA CBCS Practice Exam 2025: Certified Billing & Coding Specialist Test Bank

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Prepare for your NHA Certified Billing & Coding Specialist (CBCS) exam. Our 2025 test bank and practice exam covers medical terminology, insurance claims, ICD-10-CM, CPT coding, and reimbursement methods to help you pass your certification test.

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2025/2026
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Page 1 of 44


NHA CBCS EXAM AND PRACTICE EXAM NEWEST 2025

TEST BANK| COMPLETE 450 REAL EXAM QUESTIONS

AND CORRECT DETAILED ANSWERS (VERIFIED

ANSWERS) ALREADY GRADED A+| NHA CBCS

CERTIFICATION EXAM PREP 2025/2026 (BRAND NEW!!)

Which of the following Medicare policies determines if a

particular item or service is covered by Medicare?

.....ANSWER..... National Coverage Determination (NCD)

A patient's employer has not submitted a premium payment.

Which of the following claim statuses should the provider receive

from the third-party payer? .....ANSWER..... Denied

A billing and coding specialist should routinely analyze which of

the following to determine the number of outstanding claims?

.....ANSWER..... Aging report

,Page 2 of 44


Which of the following should a billing and coding specialist use

to submit a claim with supporting documents? .....ANSWER.....

Claims attachment

Which of the following terms is used to communicate why a claim

line item was denied or paid differently than it was billing?

.....ANSWER..... Claim adjustment codes

On a CMS-1500 claim form, which of the following information

should the billing and coding specialist enter into Block 32?

.....ANSWER..... Service facility location information

A provider's office receives a subpoena requesting medical

documentation from a patient's medical record. After confirming

the correct authorization, which of the following actions should

the billing and coding specialist take? .....ANSWER..... Send the

medical information pertaining to the dates of service requested

Which of the following is the deadline for Medicare claim

submission? .....ANSWER..... 12 months from the date of service

,Page 3 of 44


Which of the following forms does a third-party payer require

for physician services? .....ANSWER..... CMS-1500

A patient who is an active member of the military recently

returned from overseas and is in need of specialty care. The

patient does not have anyone designed with power of attorney.

Which of the following is considered a HIPAA violation?

.....ANSWER..... The billing and coding specialist sends the

patient's records to the patient's partner.

Which of the following terms refers to the difference between

the billing and allowed amounts? .....ANSWER..... Adjustment

Which of the following HMO managed care services requires a

referral? .....ANSWER..... Durable medical equipment

Which of the following explains why Medicare will deny a

particular service or procedure? .....ANSWER..... Advance

Beneficiary Notice (ABN)

, Page 4 of 44


Which of the following types of claims is 120 days old?

.....ANSWER..... Delinquent

When reviewing an established patient's insurance card, the

billing and coding specialist notices a minor change from the

existing card on file. Which of the following actions should the

billing and coding specialist take? .....ANSWER..... Photocopy

both sides of the new card

A husband and wife each have group insurance through their

employers. The wife has an appointment with her provider.

Which insurance should be used as primary for the appointment?

.....ANSWER..... The wife's insurance

Which of the following would most likely result in a denial on a

Medicare claim? .....ANSWER..... An experimental chemotherapy

medication for a patient who has stage III renal cancer
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