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NHA Medical Coding and billing exam questions and answers already graded A+ 2025/2026
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NHA Medical Coding and billing exam questions and answers already graded A+ 2025/2026
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NHA Medical Coding and billing exam1. (RAC) Recovery audit Contractor - ANS-Which of the following agencies identifies
unsuitable payments made on CMS claims
2. (S) Subjective - ANS-Soap observe to signify affected person degree of ache to issuer
3. 0% - ANS-Beneficiary of Medicaid/ Medicare crossover claim is accountable for the
share
4. 18% - ANS-Coding a front torso burn, what % should be used?
5. 2 Pieces of Information that want to be accumulated from patients - ANS-Patients name
and date of beginning
6. 2 motives a declare can be denied - ANS-Invalid subscriber name became given or
coding error was made
7. 3rd Party Payer - ANS-Insurance Carrier is a
8. 837 - ANS-Format used to submit digital claims and 3rd Party payer
9. A bilateral system - ANS-A billing and coding specialists must upload modifier -50 while
reporting which manner
10. A billing worksheet from the patient account - ANS-A prospective billing account audit
prevents fraud through reviewing & comparing a completed declare for with which of the
following files
11. A patients signature authorizing the discharge of any medical records vital to system the
declare. - ANS-Block 12
12. A Providers office with fewer than 10 fulltime employees - ANS-Medicare enforces
mandatory submission of electronic claims for most companies. Which of the carriers is
authorized to publish paper claims to Medicare?
13. Abuse - ANS-Practices that directly or indirectly bring about pointless price to the
Medicare application
14. Accounts recievable - ANS-Patient costs that have not been paid will seem wherein of
the subsequent
15. Add on Codes - ANS-Anesthesia segment of CPT guide that are taken into consideration
qualifying instances
16. adjudication - ANS-Which of the subsequent is considered the final willpower of the
troubles regarding settlement of an insurance declare
17. Advance Beneficiary Notice (ABN) - ANS-Advanced beneficiary notice, or ABN is a form
this is required for Medicare recipients.
18. An italicized code used because the 1st indexed prognosis - ANS-Result of a declare
being denied
19. APC Grouper - ANS-Determine the ideal ambulatory price category for outpatient come
across
20. Assignment of Benefits - ANS-Contract wherein the provider directly payments the payer
and accepts the allowable fee.
21. Auditing - ANS-Review of claims for accuracy and completeness
, 22. Authorization - ANS-Permission granted by using the affected person or the patients
representative to release facts for reasons aside from remedy, payment, or health care
operations
23. Billing provider NPI variety is on what block at the CMS 1500 form? - ANS-Block 33a
24. Billing the usage of 2- digit CPT Modifiers to suggest a technique as preformed differs
from its usual five digit code - ANS-Which of the following is authorized when billing
procedural codes
25. Birthday Rule - ANS-Parent whose birthday comes 1st in the calendar yr is taken into
consideration number one
26. Block 23 - ANS-A billing and coding specialists must input the previous the authorization
number on the subsequent blocks.
27. Bone and bone marrow - ANS-IF a affected person has osteomyelitis he has issues with
which of the subsequent areas?
28. Charge Description Master (CDM) - ANS-Information approximately health care services
that patients have acquired and economic transactions that have taken location.
29. Charging excessive fees - ANS-Example of Medicare abuse
30. Claim adjudication:( The term used inside the enterprise to consult the procedure of
paying claims submitted on denying them after comparing claims to the benefit or
coverage requirements) - ANS-3rd Party payer validates a declare which takes place
next
31. Claims submitted thru a comfy network - ANS-Which of the subsequent is an example of
electronic declare submission
32. Clean declare - ANS-Claim this is correct and whole
33. Clearinghouse - ANS-Agency, that converts claims into standardized electronic format,
appears for errors, and formats them according to HIPPA and coverage requirements
34. Code set standards pertain to all carriers - ANS-HIPPA compliance guideline affecting
EHR
35. Codes should correspond to the diagnosis pointer in block 24E - ANS-Diagnostic codes
in Block 21 of the CMS shape
36. Coding Compliance Plan - ANS-Which of the subsequent includes strategies and
excellent practices for correct coding
37. Coinsurance - ANS-Pre hooked up percentage of charges paid by way of the coverage
business enterprise after the deductible has been met
38. Conditional Payment - ANS-Medicare fee this is recovered after number one insurance
can pay.
39. Consent - ANS-A patients permission evidenced by way of signature
40. Contractual allowance- distinction among what hospitals invoice and what they acquire
in payment from 3rd Party Payers - ANS-Remark code from a EOB record-(EOB)-
declaration sent via a medical insurance enterprise included man or woman explaining
what clinical remedies and/ or services had been paid for on their behalf
41. Coordination of Benefit rules - ANS-Determines which coverage plan is number one and
that is secondary
42. Coordination of benefits rule - ANS-Determines which insurance plan is primary and that
is secondary insurance .
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