Exam (elaborations)
NHA CBCS EXAM REVIEW 2024/2025 graded A+
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NHA CBCS EXAM REVIEW 2024/2025 graded A+
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NHACBCS
EXAM
REVIEW
Which
of
the
following
Medicare
policies
determines
if
a
particular
item
or
service
is
covered
by
Medicare?
-
ANSNational
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?
-
ANSDenied
A
billing
and
coding
specialist
should
routinely
analyze
which
of
the
following
to
determine
the
number
of
outstanding
claims?
-
ANSAging
report
Which
of
the
following
should
a
billing
and
coding
specialist
use
to
submit
a
claim
with
supporting
documents?
-
ANSClaims
attachment
Which
of
the
following
terms
is
used
to
communicate
why
a
claim
line
item
was
denied
or
paid
differently
than
it
was
billing?
-
ANSClaim
adjustment
codes
On
a
CMS-1500
claim
form,
which
of
the
following
information
should
the
billing
and
coding
specialist
enter
into
Block
32?
-
ANSService
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?
-
ANSSend
the
medical
information
pertaining
to
the
dates
of
service
requested
Which
of
the
following
is
the
deadline
for
Medicare
claim
submission?
-
ANS12
months
from
the
date
of
service
Which
of
the
following
forms
does
a
third-party
payer
require
for
physician
services?
-
ANSCMS-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?
-
ANSThe
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?
-
ANSAdjustment
Which
of
the
following
HMO
managed
care
services
requires
a
referral?
-
ANSDurable
medical
equipment
Which
of
the
following
explains
why
Medicare
will
deny
a
particular
service
or
procedure?
-
ANSAdvance
Beneficiary
Notice
(ABN) Which
of
the
following
types
of
claims
is
120
days
old?
-
ANSDelinquent
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?
-
ANSPhotocopy
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?
-
ANSThe
wife's
insurance
Which
of
the
following
would
most
likely
result
in
a
denial
on
a
Medicare
claim?
-
ANSAn
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?
-
ANSPhone
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?
-
ANSPleurocentesis
A
patient
has
AARP
as
secondary
insurance.
In
which
of
the
following
blocks
on
the
CMS-1500
claim
form
should
the
information
be
entered?
-
ANSBlock
9
A
Medicare
non-participating
(non-PAR)
provider's
approved
payment
amount
is
$200
for
a
lobectomy
and
the
deductible
has
been
met.
Which
of
the
following
amounts
is
the
limiting
charge
for
this
procedure?
-
ANS$230
**A
non-PAR
who
does
not
accept
assignment,
can
collect
a
maximum
of
15%
(the
limiting
charge)
over
the
non-PAR
Medicare
fee
schedule
amount.
In
the
anesthesia
section
of
the
CPT
manual,
which
of
the
following
are
considered
qualifying
circumstances?
-
ANSAdd-on
codes
Threading
a
catheter
with
a
balloon
into
a
coronary
artery
and
expanding
it
to
repair
arteries
describes
which
of
the
following
procedures?
-
ANSAngioplasty
Which
of
the
following
actions
by
a
billing
and
coding
specialist
would
be
considered
fraud?
-
ANSBilling
for
services
not
provided
Which
of
the
following
statements
is
accurate
regarding
the
diagnostic
codes
in
Block
21?
-
ANSThese
codes
must
correspond
to
the
diagnosis
pointer
in
Block
24E
Which
of
the
following
parts
of
the
Medicare
insurance
program
is
managed
by
private,
third-party
insurance
providers
that
have
been
approved
by
Medicare?
-
ANSMedicare
Part
C
A
billing
and
coding
specialist
can
ensure
appropriate
insurance
coverage
for
an
outpatient
procedure
by
first
using
which
of
the
following
processes?
-
ANSPrecertification
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