NHA CBCS EXAM VERSION 3, Exams of Community Health

This NHA CBCS Exam Version 3 is an advanced, high-yield practice exam designed to closely replicate the format and difficulty of the Certified Billing and Coding Specialist certification test. It features a diverse set of exam-style questions paired with detailed rationalized answers to strengthen understanding and improve exam performance. The content covers all key domains tested on the CBCS exam, including ICD-10-CM, CPT, and HCPCS coding, medical billing workflows, insurance claims processing, and revenue cycle management. It also emphasizes patient records and documentation, reimbursement systems, HIPAA compliance, and healthcare laws.

Typology: Exams

2025/2026

Available from 05/01/2026

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NHA C BC S
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1. A specialist is submitting a batch of claims to the clearinghouse and re- ceived a
report stating threeclaims were rejected.What should the specialists next steps be?
A. Build a patient for service is not covered
B. Reviews of scrubber report
C. Call the third-party payer to determine the reason for rejection
D. Appeal the rejection
An s w
e r
Review the scrubber report
2. Which of the following actions should be taken by a specialist to ensure a patient's
health information is protected? A. Confirming test results with the patient over the
phone at the reception area.
B. Asking the patients reason for their visit during check-in.
C. Using data encryption software on office workstation.
D. Leaving the workstation unlocked while stepping away to assist another patient.
An s w
e r
Using data encryption software on office workstations
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NHA CBCS EXAM VERSION 3

Consist of 120 multichoice Questions with Answers

  1. A specialist is submitting a batch of claims to the clearinghouse and re- ceived a report stating three claims were rejected.What should the specialists next steps be? A. Build a patient for service is not covered B. Reviews of scrubber report C. Call the third-party payer to determine the reason for rejection D. Appeal the rejection Answer Review the scrubber report
  2. Which of the following actions should be taken by a specialist to ensure a patient's health information is protected? A. Confirming test results with the patient over the phone at the reception area. B. Asking the patients reason for their visit during check-in. C. Using data encryption software on office workstation. D. Leaving the workstation unlocked while stepping away to assist another patient. Answer Using data encryption software on office workstations
  1. Which of the following is an advantage of an electronic claims submission?

Answer Payment for the encounter is based on a flat rate

  1. A specialist is training a new employee on a claim for consultation.The new employee asks " What is a consultation ", which of the following responses fits best? A it's when a provider request medical advice from nursing staff.

which of the following action should a specialist take? A. Send a patient demographic information from the dates of service request- ed. B. Send a medical information pertaining to the dates of service requested. C. Send patient financial record ledger from dates of service requested. D. Send claims pertaining to the date of service as requested. Answer Send a medical information pertaining to the dates of service as requested

  1. Which of the following terms describes the removal of the eye, adnexa and bony structure? A. Evisceration B. Enucleation C. Exenteration D. Exploration Answer Exenteration
  2. Z codes are used to identify which of the following? A. Behavioral disorders. B. Digestive diseases. C. Infectious diseases. D. Immunizations. Answer Immunizations
  1. Which of the following parts of Medicare is managed by third-party payers that have been approved by Medicare A. Medicare part A B. Medicare part B C. Medicare part C D. Medicare part D Answer Medicare part C
  2. A billing specialist is reviewing a providers documents for a patient who underwent repair of multiple wounds to the face and trunk. The provider coded repair of all wouldn't individually.The specialist should recognize that the provider should have applied which of the following concepts to the documentation of the repair for this patients wounds? A. The most complex repair should only be used for coding & reporting B. The least complex repair should only be used for coding & reporting C. A maximum of 5 individual repairs should be coded & reported D. Wounds should be grouped by anatomic site and coded in order of complex- ity Answer Wounds should be grouped by anatomic site and coded in order of complexity
  3. Which of the following reasons should've claim be resubmitted? A. The software claims review process indicates the claim is not complete B. The claim needed authorization C. The claim requires an attachment to support medical necessity

D. The claim has been adjudicated 6 / 25

The payer should send reimbursement di- 7 / 25

rectly to the provider with the exception of co-pays and deductibles

  1. A specialist received a denial for payment from TRICARE for services provided in the emergency department while a provider was on a call. The provider is not a participating provider of TRICARE. Which of the following actions must a specialist take to process an appeal payment? A. File a non-availability request form. B. Request reconsideration C. Contact the patient for assistance. D. Inquire through the online tri-care portal. Answer Contact the patient for further assistance
  2. In an outpatient setting which of the following is used as a financial report of all services provider to patients? A. Encounter form B. Patient account record C. CMS - 1500 claim form. D. Accounts receivable journal Answer Patient account record
  3. Which is issued to an active duty uniformed service personnel for access to try care benefits? A. advance beneficiary notice. B. CommonAccess card. C. Release of information.

Answer Common access card

  1. A new patient presents for an urgent encounter. Which of the following codes sets should be used to report this encounter? A. Hospital observation services. B. Emergency department services. C. Office or other outpatient services D. Prolong services Answer Office or other outpatient services
  2. HIPAA transaction standards applied to which of the following entities? A. Employers who provide workers compensation plans. B. Autumn mobile insurance providers. C. Health care clearing houses. D. Educational facilities. Answer Health care clearinghouse
  3. A patient who recently received care from an Endo chronologist is being referred to an infectious disease specialist. Which of the following types of referrals does the patient need from the endocrinologist? A. A formal referral B. A direct referral C. Tertiary referral D. Self referral

Answer 9 / 25

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  1. A specialist is reviewing modifier use with a new employee. Which of the following scenarios awards the use of a modifier? A.Fracture of the left femur. B. Splinting of the fourth digit on the left foot. C. Recurrent inguinal hernia. D. Insertion of a contraceptive implant in the right arm Answer Splinting of the fourth digit on the left foot
  2. Patient is undergoing hemodialysis.The code for this procedure is found where in the CPT manual A. Urinary subsection of the surgery section. B. Medicine section. C. Cardiovascular subsection of the surgery section. D. Pathology and laboratory section Answer Medicine section
  3. Which of the sections of a capital SOAP note does a provider indicate a patient's reported level of pain? A. Subjective. B. Objective. C. Assessment. D. Plan. Answer Subjective
  4. Which of the following pieces of guarantor information is required when