NHA CBCS practice test #1 Questions with Complete Solutions

NHA CBCS practice test #1 Questions with Complete Solutions Which of the following electronic forms is used to post payments? - ANS: Electronic remittance advice (ERA) If a clean claim is received March 1 of this year, which of the following is the allowable last day of payment in order to meet Medicare compliance requirements? - ANS: March 30 Threading a catheter with balloon into a coronary artery and expanding it to repair arteries describes which of the following procedures? - ANS: Angioplasty The authorization number for a service that was approved before the service was rendered is indicated in which of the following blocks on the CMS-1500 claim form? - ANS: Block 23 Which of the following blocks of the CMS-1500 claim form indicates an ICD diagnosis code? - ANS: Block 21 A patient who has an HMO insurance plan needs to see a specialist for a specific problem. From which of the following should the patient obtain an referral? - ANS: Primary Care Provider 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? - ANS: Pleurocentesis Which of the following standardized formats are used in the electronic filing of claims? - ANS: HIPAA standard transactions Which of the following blocks on the CMS-1500 claim form is used to accept assignment of benefit? - ANS: Block 27 On the CMS-1500 claim form, blocks 14 through 33 contain information about which of the following? - ANS: The patient's condition and the provider's information The explanation of benefits states the amount billed was $80. The allowed amount is $60, and the patient is required to pay a $20 copayment. Which of the following describes the insurance check amount to be posted? - ANS: $40 Which of the following should a billing coding specialist use to submit a claim with supporting documents? - ANS: Claims Attachment 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? - ANS: Photo copy both sides of the card Which of the following accurately describes code symbols found in the CPT manual? - ANS: A product pending FDA approval is indicated as a lightning-bolt symbol Which of the following Medicare policies determines if a particular item or service is covered by Medicare? - ANS: National Coverage Determination (NCD) Which of the following options is considered proper supportive documentation for reporting CPT and ICD codes for surgical procedures? * - ANS: Operative report Which of the following is an example of a remark code from an explanation of benefits document? - ANS: Contractual allowance Which of the following forms should the billing and coding specialist transmit to the insurance carrier for reimbursement of inpatient hospital services? - ANS: UB-04 A claim is denied due to termination of coverage. Which of the following actions should the billing and coding specialist take next? - ANS: Follow up with the patient to determine current name, address, and insurance carrier for resubmission Which of the following national provider identifiers (NPIs) is required in Block 33a of a CMS-1500 claim form? - ANS: Billing provider Which of the following is a reason a claim would be denied? - ANS: Incorrectly linked codes The unlisted codes can be found in which locations in the CPT manual? - ANS: The guidelines prior to each section When the remittance advice is sent from the third-party payer to the provider, which of the following actions should the billing and coding specialist perform first? - ANS: Ensure proper payment has been made Which of the following symbols indicates a revised code? - ANS: Triangle Which of the following terms is used to describe the location of the stomach, the spleen, part of the pancreas, part of the liver, and part of the small and large intestines? - ANS: Left Upper Quadrant When coding a front torso burn, which of the following percentages should be coded? - ANS: 18% Which of the following is true regarding Medicaid eligibility? - ANS: Patient eligibility is determined monthly Which of the following describes a key component of an evaluation and management service? - ANS: History Which of the following is considered fraud? - ANS: The billing and coding specialist unbundles a code to receive higher reimbursement Which of the following is an example of Medicare abuse? - ANS: Charging Excessive fees Which of the following privacy measures ensures protected health information (PHI)? - ANS: Using data encryption software on office workstations