NHA - Certified Billing And Coding Specialist (CBC
NHA - Certified Billing and Coding Specialist (CBC
Exam (elaborations)
NHA - Certified Billing and Coding Specialist (CBCS) Questions and Answers 2025
6 views 0 purchase
Course
NHA - Certified Billing and Coding Specialist (CBC
Institution
NHA - Certified Billing And Coding Specialist (CBC
NHA - Certified Billing and Coding Specialist (CBCS) Questions and Answers 2025
The symbol "O" in the Current Procedural Terminology reference is used to indicate what? - Correct Answer: Reinstated or recycled code
In the anesthesia section of the CPT manual, what are considered qualifying ci...
NHA - Certified Billing and Coding Specialist (CBCS)
Questions and Answers 2025
The symbol "O" in the Current Procedural Terminology reference is used to indicate what? -
Correct Answer: Reinstated or recycled code
In the anesthesia section of the CPT manual, what are considered qualifying circumstances? -
Correct 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? - Correct Answer: 12
What is considered proper supportive documentation for reporting CPT and ICD codes for surgical
procedures? - Correct Answer: Operative report
What action should be taken first when reviewing a delinquent claim? - Correct Answer: Verify the
age of the account
A claim can be denied or rejected for which of the following reasons? - Correct Answer: Block 24D
contains the diagnosis code
A coroner's autopsy is comprised of what examinations? - Correct Answer: Gross Examination
Medigap coverage is offered to Medicare beneficiaries by whom? - Correct Answer: Private third-
party payers
What part of Medicare covers prescriptions? - Correct Answer: Part C
What plane divides the body into left and right? - Correct Answer: Sagittal
Where can unlisted codes be found in the CPT manual? - Correct Answer: Guidelines prior to each
section
Ambulatory surgery centers, home health care, and hospice organizations use which form to
submit claims? - Correct Answer: UB-04 Claim Form
What color format is acceptable on the CMS-1500 claim form? - Correct Answer: Red
Who is responsible to pay the deductible? - Correct Answer: Patient
, A patient's health plan is referred to as the "payer of last resort." What is the name of that health
plan? - Correct Answer: Medicaid
Informed Consent - Correct 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 - Correct Answer: A patient presents for treatment, such as extending an arm to
allow a venipuncture to be performed.
Clearinghouse - Correct Answer: Agency that converts claims into standardized electronic format,
looks for errors, and formats them according to HIPAA and insurance standards.
Individually Identifiable - Correct Answer: Documents that identify the person or provide enough
information so that the person can be identified.
De-identified Information - Correct Answer: Information that does not identify an individual because
unique and personal characteristics have been removed.
Consent - Correct Answer: A patient's permission evidenced by signature.
Authorizations - Correct Answer: Permission granted by the patient or the patient's representative
to release information for reasons other than treatment, payment, or health care operations.
Reimbursement - Correct Answer: Payment for services rendered from a third-party payer.
Auditing - Correct Answer: Review of claims for accuracy and completeness.
Fraud - Correct Answer: Making false statements of representations of material facts to obtain
some benefit or payment for which no entitlement would otherwise exist.
Upcoding - Correct Answer: Assigning a diagnosis or procedure code at a higher level than the
documentation supports, such as coding bronchitis as pneumonia.
Unbundling - Correct Answer: Using multiple codes that describe different components of a
treatment instead of using a single code that describes all steps of the procedure.
Abuse - Correct Answer: Practices that directly or indirectly result in unnecessary costs to the
Medicare program.
Business Associate (BA) - Correct Answer: Individuals, groups, or organizations who are not
members of a covered entity's workforce that perform functions or activities on behalf of or for a
covered entity.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Nurslink. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.49. You're not tied to anything after your purchase.
