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CBCS Final Exam Questions
& Answers 2022/2023
1.When a billing and coding specialist is completing the CMS-1500
claim form, which of the following information is required to process a
medical claim (Answer) CPT, ICD
- The allowed amount for a patient’s office visit is $175. The copayment is$15 and the amount the insurance paid is $85. Which of the following is the
amount of the adjustment (Answer) $75
3.Which of the following suffixes refers to an abnormal condition (Answer)
-osis
4.Which of the following entities contracts with Medicare to recoup
money form inappropriately paid claims (Answer) Recovery Audit
Contractor
5.Which of the following abbreviations is used to describe the reason
a patient presents for an encounter at the office visit (Answer) CC
6.A patient comes in the office with an injury form work. Which box on line
1 of the CMS-1500 claim from should the billing and coding specialist
check off to transmit the calm for payment (Answer) FECA
7.Which of the following physical status modifiers should the billing and
coding specialist use to indicate a healthy patient who has no evidence
of disease at the time of anesthesia administration (Answer) P1
8.Which of the following practices does HIPPA Title II define as fraud
(Answer) Alter- ing codes to increase payment
9.A provider charges $30 for a treatment that has an allowed of $25.
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Which of the following statements regarding this $5 difference between
the two amounts is correct (Answer) The insurance payer pays the $5 if
the provider is a par- ticipating provider.
10.A patient who has coinsurance and has met their deductible has
which of the following third-party payers (Answer) Preferred provider
organization(PPO)
11.If a patient does not sign box 13 on the CMS-1500 form. Which of
the following will receive payment (Answer) Provider
12.Which is the correct form (Answer) Thomas Jr. Martin F
13.A patient has a diagnosis of chest pain. The billing and coding
specialist should link the diagnosis to the procedure in which of the
following blocks on the CMS- 1500 form (Answer) 24D
14.A provider’s office is being investigated for fraud. Which of the
following processes will be reviewed first (Answer) Compliance Plan
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15.Which of the following entities works with Centers for Medicare and
Medicaid services to prevent overpayment (Answer) Medicaid Integrity
contractors
16.Which of the following actions by a billing and coding specialist is
insurance abuse (Answer) Using a health insurance identification
number other than the patients to ensure payments
17.Which of the following refers to payers electronically transferring date
in order to facilitate coordination of benefits on a clean claim (Answer)
Crossover
- Which of the following is responsible for the health care of its
policyhold- ers and identifies health insurance, facilities, providers, or
health systems?-
: Managed care Organization
19.A patient who has TRICARE is seen in the office for a diagnostic test.
The test is $500, and the allowable amount is $250. The patient has a 20%
cost share, a deductible of $1000, and a catastrophic cap benefit that have
all been met. How much should the billing specialist adjust on this visit
(Answer) $200
20.Which of the following is the amount that the patient is financially
respon- sible for before the insurance policy provides coverage (Answer)
Deductible
21.The balances listed on an insurance aging report represent which of
the following (Answer) Outstanding amounts owed to the practice
22.To ensure all claims are being submitted and received, a billing and
coding specialist should document all claims processing on which of
the following (Answer) An aging insurance report
23.Which of the following terms describes a procedure that visualizes
the inside of a knee (Answer) Arthrography
24.The field ” Insured’s ID Number” located on the CMS-1500 claim form
is used to report which of the following pieces of information (Answer)