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NHA Practice Exam –Questions With Complete Answers
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NHA Practice Exam –Questions With Complete AnswersA billing and coding specialist is reviewing delinquent claims and discovers
that a third-party payer paid a claim that applied to the incorrect provider.
The third-party payer will reimburse the payment once the improperly paid
funds are we occupied which of the following terms is used to describe this
claim? Correct Ans - Suspend
billing and coding specialist is reviewing a remittance advance and encounters
a denial of payment for CPT code 44950 (appendectomy). The specialist
discovers the ICD 10 CM code assigned to the case was J32.1(chronic frontal
sinusitis) which of the following is a reason for this claim denial? Correct
Ans - Incorrectly linked codes were reported to the claim
The billing and coding specialist is reviewing it claim that was denied for
services provided during the postoperative period. The patient was diagnosed
with pneumonia during a postoperative encounter for a knee joint
replacement two weeks ago. Which of the following modifiers should a
specialist add to the client prior to resubmitting Correct Ans - -24
Which of the following actions should a biller and coder specialist take to
assign a diagnosis code to the highest level of specificity Correct Ans -
Apply characters four through seven to a claim
Which of the following information is required on a patient's account record
Correct Ans - Name and address of Guarantor
Which of the following is a valid ICD 10 CM principal Correct Ans -
Code signs and symptoms in the absence of a definitive diagnosis
The star symbol in the CPT coding manual is used to indicate which of the
following Correct Ans - Telemedicine
A billing and coding specialist is determining coordination of benefits for a
patient who is health insurance covered from both parents the patient's
father's birthday is in March 18, 1982 and the mothers birthday is May 18,
1984 which of the following statements is correct for determining coverage
Correct Ans - The parents who insurance policy has been acted the longest
will be the primary insurer
,Which of the following links the ICD 10 CM and CPT codes for claims
processing Correct Ans - Diagnosis pointer
A providers office fee is $100 and the Medicare part B allowed amount is $85.
Assuming they've been a beneficiary has not met their annual deductible, the
patient should be billed for which of the following amounts Correct Ans -
$85
A billing and coding specialist is preparing a claim for a procedure with a
prolonged operative time that has modifier -22 attached. Which of the
following actions should the specialist take. Correct Ans - Send a copy
of the operator report with the claim
Z Codes are used to identify which of the following Correct Ans -
Immunizations
Which of the following is a federal government health insurance program
Correct Ans - Tricare
A billing and coding specialist is reviewing modifier use with the new
employee. Which of the following scenarios warns the use of a modifier
Correct Ans - Splitting the four digit on the left foot
Billing and coding specialist is preparing to appeal a partially paid claim due
to incorrect procedure code. Which of the following steps of the appeal
process includes the review of the claim adjustment reason code? Correct
Ans - Identification
Which of the following CPT codes should a billing and coding specialist used to
be all for a five year old child who had a hernia repair? Correct Ans -
49585
Billing and coding specialist is reviewing a patient's encounter progress note.
Which of the following modifiers indicates the patient receive general
anesthesia from a surgeon? Correct Ans - -47
A patient who recently received care be an endocrinologist. The
endocrinologist is being referred to an infectious disease specialist. Which of
, the following types of referral does the patient need from their
endocrinologist? Correct Ans - Tertiary care referral
A billing specialist is reviewing a remittance advice for Medicare and notices
that the amount paid for a procedure is less than the contract amount which
of the following is a potential reason they reduced amount of payment?
Correct Ans - The claim indicated incorrect place of service
The billing and coding specialist is submitting a claim for a 5 year old child he
was brought to the clinic by their maternal grandmother. The child's parents
are divorced and remarried. And the child's mother has legal custody of the
child, the specialist should recognize that the child's primary insurance
coverage is provided through which of the following insured individuals.
Correct Ans - Biological mother
A child was bought into a facility by their mother. The child is covered under
both parents insurance policies. The child's father was born on 10 one 1980
and their mother was born on 10 to 1981 which of the following statements is
true regarding the primary policy holder for the child. Correct Ans -
The father is the primary policyholder because his birthday falls first in the
calendar year
Which of the following is a purpose of running an insurance aging report each
month Correct Ans - To determine which claims are outstanding from
third-party payers
Which of the following statements is true regarding the release efficient
records Correct Ans - Patient access to psychotherapy notes is
restricted.
A billing and coding specialist is preparing a claim for a patient who had a
procedure performed on their left index finger which of the following
modifiers indicates the correct digit Correct Ans - -F1
Billing and coding specialist is processing the claim for the patient who broke
their arm while repairing cars at their workplace. There is no nerve damage.
The arm is placed in a cast for six weeks. The patient is clear to work in six
weeks. Which of the following type of workers compensation apply to this
patient Correct Ans - Temporary disability
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