NHA - Certified Billing and Coding
Specialist (CBCS) Study Guide
The symbol "O" in the Current Procedural Terminology reference is used to indicate what? - Answer -
Reinstated or recycled code
In the anesthesia section of the CPT manual, what are considered qualifying circumstances? - 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? - Answer -12
What is considered proper supportive documentation for reporting CPT and ICD codes for surgical
procedures? - Answer -Operative report
What action should be taken first when reviewing a delinquent claim? - Answer -Verify the age of the
account
A claim can be denied or rejected for which of the following reasons? - Answer -Block 24D contains the
diagnosis code
, A coroner's autopsy is comprised of what examinations? - Answer -Gross Examination
Medigap coverage is offered to Medicare beneficiaries by whom? - Answer -Private third-party payers
What part of Medicare covers prescriptions? - Answer -Part C
What plane divides the body into left and right? - Answer -Sagittal
Where can unlisted codes be found in the CPT manual? - Answer -Guidelines prior to each section
Ambulatory surgery centers, home health care, and hospice organizations use which form to submit
claims? - Answer -UB-04 Claim Form
What color format is acceptable on the CMS-1500 claim form? - Answer -Red
Who is responsible to pay the deductible? - Answer -Patient
A patient's health plan is referred to as the "payer of last resort." What is the name of that health plan? -
Answer -Medicaid
Informed Consent - 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 - Answer -A patient presents for treatment, such as extending an arm to allow a
venipuncture to be performed.
Clearinghouse - Answer -Agency that converts claims into standardized electronic format, looks for
errors, and formats them according to HIPAA and insurance standards.
Specialist (CBCS) Study Guide
The symbol "O" in the Current Procedural Terminology reference is used to indicate what? - Answer -
Reinstated or recycled code
In the anesthesia section of the CPT manual, what are considered qualifying circumstances? - 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? - Answer -12
What is considered proper supportive documentation for reporting CPT and ICD codes for surgical
procedures? - Answer -Operative report
What action should be taken first when reviewing a delinquent claim? - Answer -Verify the age of the
account
A claim can be denied or rejected for which of the following reasons? - Answer -Block 24D contains the
diagnosis code
, A coroner's autopsy is comprised of what examinations? - Answer -Gross Examination
Medigap coverage is offered to Medicare beneficiaries by whom? - Answer -Private third-party payers
What part of Medicare covers prescriptions? - Answer -Part C
What plane divides the body into left and right? - Answer -Sagittal
Where can unlisted codes be found in the CPT manual? - Answer -Guidelines prior to each section
Ambulatory surgery centers, home health care, and hospice organizations use which form to submit
claims? - Answer -UB-04 Claim Form
What color format is acceptable on the CMS-1500 claim form? - Answer -Red
Who is responsible to pay the deductible? - Answer -Patient
A patient's health plan is referred to as the "payer of last resort." What is the name of that health plan? -
Answer -Medicaid
Informed Consent - 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 - Answer -A patient presents for treatment, such as extending an arm to allow a
venipuncture to be performed.
Clearinghouse - Answer -Agency that converts claims into standardized electronic format, looks for
errors, and formats them according to HIPAA and insurance standards.
