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CBCS Practice Test/300 Exam Questions with Solutions
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CBCS Practice Test/300 ExamQuestions with Solutions
Which of the following sections of the medical record is used to determine
the correct evaluation and management code used for billing and coding? - -
history and physical
-A billing and coding specialist is reviewing a CMS-1500 claim form. The
"assignment of benefits" box has been checked "yes." The checked box
indicates which of the following? - -The provider receives payment directly
from the payer
-Which of the following do physicians use to electronically submit a claim? -
-Clearinghouse
-Which of the following should the billing and coding specialist include in an
authorization to release information? - -The entity to whom the information
is to be released
-Which of the following describes the content of a medical practice aging
report? - -An overview of the practice's outstanding claims
-HIPAA transaction standards apply to which of the following entities? - -
Health care clearinghouses
-When a physician documents a patient's response to symptoms and various
body systems, the results are documented as which of the following? - -
Review of systems
-Which part of Medicare covers prescriptions? - -Part D
-Which of the following indicates a claim should be submitted on paper
instead of electronically? - -The claim requires an attachment
-Medicare enforces mandatory submission of electronic claims for most
providers. Which of the following providers is allowed to submit paper claims
to Medicare? - -A provider's office with fewer than 10 full-time employees
-Which of the following is the correct term for an amount that has been
determined to be uncollectible? - -Bad debt
-Which of the following statements are correct regarding a deductible? - -
The deductible is the patient's responsibility
, -Which of the following statements is true regarding the release of patient
records? - -Patient access to psychotherapy notes may be restricted
-Why does correct claim processing rely on accurately completed encounter
forms? - -They streamline patient billing by summarizing the services
rendered for a given date of service
-When posting payment accurately. Which of the following items should the
billing and coding specialist include? - -Patient's responsibility
-A dependent child whose parents both have insurance coverage come to
the clinic. The billing and coding specialist uses the birthday rule determine
which insurance policy is primary. Which of the following describes the
birthday rule? - -The patient whose birthday comes first in the calendar year
-Which of the following actions should the billing and coding specialist take
to effectively manage accounts receivable? - -Collect copayment from the
patient at the time of service
-If a patient has osteomyelitis, he has problems with which of the following
areas? - -bones, bone marrow
-Which of the following are used by providers to remove errors from claims
before they are submitted to third-party payers? - -Clearinghouse
-A provider receives a reimbursement from a third-party payer accompanied
by which of the following documents? - -explanation of benefits
-Which of the following is the appropriate diagnosis for a patient who has an
abnormal accumulation of fluid in her lower leg that has resulted in swelling?
- -Edema
-Which of the following blocks on the CMS-1500 claim form is used to bill ICD
codes? - -Block 21
-Patient charges that have not been paid to appear in which of the
following? - -Accounts receivable
-A physician is contracted with an insurance company to accept the allowed
amount. The insurance company allows $80 of a $120 billed amount, And
$50 of the deductible has not been met. How much should the physician
write off the patient's record? - -$40
This is the difference between the amount billed and allowed amount. The
physician should write off $40.
, -A provider performs an examination of a patient sore throat during an office
visit. Which of the following describes the level of the examination? - -
Problem-focused examination
-When building a secondary insurance company, which block should be
billing and coding specialist fill out on the CMS-1500 claim form? - -9a
-Which of the following forms must be patient or representative sign to allow
the release of protected health information? - -An Authorization
-What is the maximum number of ICD codes that can be entered on a CMS-
1500 claim form as of February 2012? - -12
-After a third-party payer validates a claim, which of the following takes
place next? - -Claim adjudication
-When a patient has a condition that is both acute and chronic, how should I
be reported? - -Code both acute and chronic sequencing the acute first
-Which of the following acts applies to the Administrative Simplification
guidelines? - -Health Insurance Portability and Accountability Act (HIPAA)
-After reading a providers notes about a new patient, a coding specialist
decides to code for a longer length of time than the actual office visit. Which
of the following describes the specialist's action? - -Fraud
-A biller will electronically submit a claim to the carrier via which of the
following? - -Direct Data Entry
-Which of the following is the purpose of running an aging report each
month? - -It indicates which claims are outstanding
-Which of the following is a type of claim that will be denied by the third-
party payer? - -incomplete claim
-Which of the following actions should the billing and coding specialist take
to prevent fraud and abuse in the medical office? - -Internal monitoring and
auditing
-Which of the following is a verbal or written agreement that gives approval
to release protected health information (PHI)? - -consent
-Which of the following is a requirement of some Third-party payers before a
procedure is performed? - -Preauthorization form
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