TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS
RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
NHA - Certified Billing and Coding
Specialist (CBCS) Study Guide
Questions with Correct Answers
The symbol "O" in the Current Procedural Terminology reference is used to indicate
what? - Correct Answer✔️✔️-Reinstated or recycled code
In the anesthesia section of the CPT manual, what are considered qualifying
circumstances? - Correct Answer✔️✔️-Add-on codes
As of April 1, 2014 what is the maximum number of diagnoses that can be reported on
the CMS-1500 claim form before a further claim is required? - Correct Answer✔️✔️-12
What is considered proper supportive documentation for reporting CPT and ICD codes
for surgical procedures? - Correct Answer✔️✔️-Operative report
What action should be taken first when reviewing a delinquent claim? - Correct
Answer✔️✔️-Verify the age of the account
A claim can be denied or rejected for which of the following reasons? - Correct
Answer✔️✔️-Block 24D contains the diagnosis code
A coroner's autopsy is comprised of what examinations? - Correct Answer✔️✔️-Gross
Examination
1/18
,TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS
RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
Medigap coverage is offered to Medicare beneficiaries by whom? - Correct Answer✔️✔️-
Private third-party payers
What part of Medicare covers prescriptions? - Correct Answer✔️✔️-Part C
What plane divides the body into left and right? - Correct Answer✔️✔️-Sagittal
Where can unlisted codes be found in the CPT manual? - Correct Answer✔️✔️-
Guidelines prior to each section
Ambulatory surgery centers, home health care, and hospice organizations use which
form to submit claims? - Correct Answer✔️✔️-UB-04 Claim Form
What color format is acceptable on the CMS-1500 claim form? - Correct Answer✔️✔️-
Red
Who is responsible to pay the deductible? - Correct Answer✔️✔️-Patient
A patient's health plan is referred to as the "payer of last resort." What is the name of
that health plan? - Correct Answer✔️✔️-Medicaid
Informed Consent - Correct Answer✔️✔️-Providers explain medical or diagnostic
procedures, surgical interventions, and the benefits and risks involved, giving patients
an opportunity to ask questions before medical intervention is provided.
Implied Consent - Correct Answer✔️✔️-A patient presents for treatment, such as
extending an arm to allow a venipuncture to be performed.
2/18
, TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS
RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
Clearinghouse - Correct Answer✔️✔️-Agency that converts claims into standardized
electronic format, looks for errors, and formats them according to HIPAA and insurance
standards.
Individually Identifiable - Correct Answer✔️✔️-Documents that identify the person or
provide enough information so that the person can be identified.
De-identified Information - Correct Answer✔️✔️-Information that does not identify an
individual because unique and personal characteristics have been removed.
Consent - Correct Answer✔️✔️-A patient's permission evidenced by signature.
Authorizations - Correct Answer✔️✔️-Permission granted by the patient or the patient's
representative to release information for reasons other than treatment, payment, or
health care operations.
Reimbursement - Correct Answer✔️✔️-Payment for services rendered from a third-party
payer.
Auditing - Correct Answer✔️✔️-Review of claims for accuracy and completeness.
Fraud - Correct Answer✔️✔️-Making false statements of representations of material facts
to obtain some benefit or payment for which no entitlement would otherwise exist.
Upcoding - Correct Answer✔️✔️-Assigning a diagnosis or procedure code at a higher
level than the documentation supports, such as coding bronchitis as pneumonia.
3/18
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS
RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
NHA - Certified Billing and Coding
Specialist (CBCS) Study Guide
Questions with Correct Answers
The symbol "O" in the Current Procedural Terminology reference is used to indicate
what? - Correct Answer✔️✔️-Reinstated or recycled code
In the anesthesia section of the CPT manual, what are considered qualifying
circumstances? - Correct Answer✔️✔️-Add-on codes
As of April 1, 2014 what is the maximum number of diagnoses that can be reported on
the CMS-1500 claim form before a further claim is required? - Correct Answer✔️✔️-12
What is considered proper supportive documentation for reporting CPT and ICD codes
for surgical procedures? - Correct Answer✔️✔️-Operative report
What action should be taken first when reviewing a delinquent claim? - Correct
Answer✔️✔️-Verify the age of the account
A claim can be denied or rejected for which of the following reasons? - Correct
Answer✔️✔️-Block 24D contains the diagnosis code
A coroner's autopsy is comprised of what examinations? - Correct Answer✔️✔️-Gross
Examination
1/18
,TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS
RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
Medigap coverage is offered to Medicare beneficiaries by whom? - Correct Answer✔️✔️-
Private third-party payers
What part of Medicare covers prescriptions? - Correct Answer✔️✔️-Part C
What plane divides the body into left and right? - Correct Answer✔️✔️-Sagittal
Where can unlisted codes be found in the CPT manual? - Correct Answer✔️✔️-
Guidelines prior to each section
Ambulatory surgery centers, home health care, and hospice organizations use which
form to submit claims? - Correct Answer✔️✔️-UB-04 Claim Form
What color format is acceptable on the CMS-1500 claim form? - Correct Answer✔️✔️-
Red
Who is responsible to pay the deductible? - Correct Answer✔️✔️-Patient
A patient's health plan is referred to as the "payer of last resort." What is the name of
that health plan? - Correct Answer✔️✔️-Medicaid
Informed Consent - Correct Answer✔️✔️-Providers explain medical or diagnostic
procedures, surgical interventions, and the benefits and risks involved, giving patients
an opportunity to ask questions before medical intervention is provided.
Implied Consent - Correct Answer✔️✔️-A patient presents for treatment, such as
extending an arm to allow a venipuncture to be performed.
2/18
, TITLE: EMILLYCHARLOTTE 2024/2025 ACADEMIC PERIOD
OWNER: EMILLYCHARLOTTE
COPYRIGHT STATEMENT: ©2024 EMILLYCHARLOTTE. ALL RIGHTS
RESERVED
FIRST PUBLISHED: SEPTEMBER 2024
Clearinghouse - Correct Answer✔️✔️-Agency that converts claims into standardized
electronic format, looks for errors, and formats them according to HIPAA and insurance
standards.
Individually Identifiable - Correct Answer✔️✔️-Documents that identify the person or
provide enough information so that the person can be identified.
De-identified Information - Correct Answer✔️✔️-Information that does not identify an
individual because unique and personal characteristics have been removed.
Consent - Correct Answer✔️✔️-A patient's permission evidenced by signature.
Authorizations - Correct Answer✔️✔️-Permission granted by the patient or the patient's
representative to release information for reasons other than treatment, payment, or
health care operations.
Reimbursement - Correct Answer✔️✔️-Payment for services rendered from a third-party
payer.
Auditing - Correct Answer✔️✔️-Review of claims for accuracy and completeness.
Fraud - Correct Answer✔️✔️-Making false statements of representations of material facts
to obtain some benefit or payment for which no entitlement would otherwise exist.
Upcoding - Correct Answer✔️✔️-Assigning a diagnosis or procedure code at a higher
level than the documentation supports, such as coding bronchitis as pneumonia.
3/18
