NHA- CBCS EXAM REVIEW Questions Answered (Verified
Solutions) 2023
A _________________ would be the provider who would
perform an orchiopexy – correct answer ✅UROLOGIST
The first section of the CPT manual is the
_________________________________. – correct answer
✅EVALUATION AND MANAGEMENT CODES
________________ means the amount of reimbursement an
insurance payer and patient agrees to pay a provider. – correct answer
✅ALLOWED AMOUNT
A billing and coding specialist should determine first, the
_________ to determine an appropriate e/m code. – correct
answer ✅PLACE OF SERVICE
The appendix is located in the _________________________
of the abdomen. – correct answer ✅LOWER RIGHT QUADRANT
NHA- CBCS EXAM REVIEW Questions Answered (Verified
Solutions) 2023
For a patient whose insurance coverage is from her partner, the
________________________ is required to bill her claim. –
correct answer ✅POLICY NUMBER
An exposure to tuberculosis requires a
__________________________. – correct answer ✅V CODE
A billing and coding specialist should use
___________________________________ when transmitting
a claim for a minor without health insurance. – correct answer
✅GUARANTOR INFORMATION
The ________________________ investigates cases of fraud
and prepares a referral for prosecution. – correct answer ✅OFFICE OF THE
INSPECTOR GENERAL
An insurance claim is considered a __________________
when further reviewed by the insurance company, is not necessary before
submitting the claim. – correct answer ✅CLEAN CLAIM
NHA- CBCS EXAM REVIEW Questions Answered (Verified
Solutions) 2023
A billing and coding specialist should
______________________________________to identify areas of risk associated with billing compliance. – correct answer ✅PERFORM INTERNAL AUDITS TO MONITOR THE BILLING PROCESS When _____________________________________, then it is said to
be in a state of homeostasis. – correct answer ✅THE BODY MAINTAINS
NORMAL BALANCE AND FUNCTION
The _______________________ is an example of an
electronic claim format. – correct answer ✅ANSI ASC X12 837
The _____________________________information is included in an electronic remittance advice. – correct answer ✅PATIENT’S DEDUCTIBLE The provider performed an _______________ if a lesion needed to
be removed with no pathology report and the billing and coding specialist is
coding from the integumentary system. – correct answer ✅EXCISION
NHA CBCS EXAM Questions and Answers (with correct
solutions) 2023 Certified exam
Which of the following Medicare policies determines if a particular item or
service is covered by Medicare? – correct 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? – correct answer ✅Denied
A billing and coding specialist should routinely analyze which of the following
to determine the number of outstanding claims? – correct answer ✅Aging
report
Which of the following should a billing and coding specialist use to submit a
claim with supporting documents? – correct 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? – correct answer ✅Claim
adjustment codes
NHA CBCS EXAM Questions and Answers (with correct
solutions) 2023 Certified exam
On a CMS-1500 claim form, which of the following information should the
billing and coding specialist enter into Block 32? – correct 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? –
correct answer ✅Send the medical information pertaining to the dates of
service requested
Which of the following is the deadline for Medicare claim submission? –
correct answer ✅12 months from the date of service
Which of the following forms does a third-party payer require for physician
services? – correct 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? – correct answer ✅The billing and coding specialist sends
the patient’s records to the patient’s partner.
NHA CBCS EXAM Questions and Answers (with correct
solutions) 2023 Certified exam
Which of the following terms refers to the difference between the billing and
allowed amounts? – correct answer ✅Adjustment
Which of the following HMO managed care services requires a referral? –
correct answer ✅Durable medical equipment
Which of the following explains why Medicare will deny a particular service
or procedure? – correct answer ✅Advance Beneficiary Notice (ABN)
Which of the following types of claims is 120 days old? – correct 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? –
correct answer ✅Photocopy both sides of the new card
NHA CBCS EXAM Questions and Answers (with correct
solutions) 2023 Certified exam
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? – correct answer ✅The wife’s insurance
Which of the following would most likely result in a denial on a Medicare
claim? – correct answer ✅An experimental chemotherapy medication for a
patient who has stage III renal cancer
Which of the following pieces of guarantor information is required when
establishing a patient’s financial record? – correct answer ✅Phone number
A provider surgically punctures through the space between the patient’s ribs
using an aspirating needle to withdraw fluid from the chest cavity. Which of
the following is the name of this procedure? – correct answer
✅Pleurocentesis
A patient has AARP as secondary insurance. In which of the following blocks
on the CMS-1500 claim form should the information be entered? – correct
answer ✅Block 9
NHA CBCS Certification study guide Exam Q&AS (with
verified solutions) 130qs
Standards of conduct based on moral principals. Acting within ethical
behavior boundries means carrying out one’s responsibilities with integrity,
decency, respect, honesty, competence, fairness and trust. – correct answer
✅Medical Ethics
Most billing related cases are based on HIPAA and the False Claims Act. –
correct answer ✅Compliance Regulations
Health Insurance Portability and Accountability Act of 1996. – correct answer
✅HIPAA is an acronym for
Medical Procedures. – correct answer ✅Category 1 CPT codes
Supplemental Codes for Performance Measures. – correct answer
✅Category 2 CPT codes
Emerging Technologies. – correct answer ✅Category 3 CPT codes
NHA CBCS Certification study guide Exam Q&AS (with
verified solutions) 130qs
Used for procedures that are always performed during the same operative
session, as another surgery in addition to the primary service/procedure and
is never performed separately. – correct answer ✅Add on Codes
00100-01999, 99100-99140. – correct answer ✅Anesthesia is found
Are listed first in the CPT manual because they are used by all the different
specialties. – correct answer ✅Evaluation and Management (E&M) codes
Used to enclose synonyms, alternative wording or and explanatory phrase. –
correct answer ✅Brackets
Represents a new procedure or service code added since the previous
edition of the manual. – correct answer ✅Bullets
The reason the patient came to see the physician. – correct answer ✅Chief
Complaint (CC)
NHA CBCS Certification study guide Exam Q&AS (with
verified solutions) 130qs
Exemption from modifier 51. – correct answer ✅Circle with a line through it
(????)
Used to report services and procedures by physicians. – correct answer
✅CPT
99201-99499 – correct answer ✅E&M codes
At the beginning of each section and used to provide specific coding rules for
that section. – correct answer ✅Guidelines are found
The set of information the physician gathers from the patient concerning
his/her past. – correct answer ✅History (HX)
A chronological account of the development of the complaint from the first
sign or symptom that the patient experienced to the present. – correct
answer ✅History of Present Illness (HPI)
NHA CBCS Certification Practice Exam A Latest Update
2023 (Verified Solutions)
Which of the following is considered the final determination of the issues
involving the settlement of an insurance claim? – correct answer
✅Adjudication – is the process of putting an insurance claim through a series
of edits for final determination.
Chapter 4
A form that contains charges, DOS, CPT codes, fees, and copayment
information is called which of the following? – correct answer ✅Encounter
form is a form that contains charges, DOS, CPT code, ICD codes, fees, and
copayment information.
page 67
A patient comes to the hospital for an inpatient procedure. Which of the
following hospital staff members is responsible for the initial patient
interview, obtaining demographic and insurance information, and
documenting the chief complaint? – correct answer ✅Admitting these
duties clerk has Chapter 3
Which of the following privacy measures ensures protected health
information (PHI)? – correct answer ✅Using data encryption software on
office workstations – encryption software ensures that electronically
NHA CBCS Certification Practice Exam A Latest Update
2023 (Verified Solutions)
transmitted health information cannot be read by third parties. This privacy
measure guarantees PHI.
Chapter 1
Which of the following planes divide the body into left and right? – correct
answer ✅Sagittal plane divides the body into right and left sections
Which of the following provisions ensures that an insured’s benefits from all
insurance companies do not exceed 100% of allowable medical expenses? –
correct answer ✅Coordination of benefits ensures that the insured benefits
from all insured companies do not exceed 100% of allowable medical
expenses.
page 16
Which of the following actions should be taken first when reviewing a
delinquent claim? – correct answer ✅Verify the age of the account is the
first action.
page 45
NHA CBCS Certification Practice Exam A Latest Update
2023 (Verified Solutions)
Which of the following is the advantage of electronic claim submission? –
correct answer ✅Claims are expedited – submitting claims electronically is
faster than submitting paper claims.
page 15
Which of the following components of an explanation of benefits expedites
the process of a phone appeal? – correct answer ✅Claim control number
expedites the process of a phone appeal.
Chapter 4
The standard medical abbreviation “ECG” refers to a test used to assess
which of the following body systems? – correct answer ✅Cardiovascular
system- which is a test that checks for problems with the electrical activity of
the heart.
Chapter 5
Which of the following actions by a billing coding specialist (bcs) would be
considered fraud? – correct answer ✅Billing for a service not provided is
considered fraud and can result in fines for the bcs and the physician page 6