CBCS Cheat Sheet 2026

The 30 highest-yield CBCS facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. In ICD-10-CM, which POA indicator is assigned when the condition could not be determined as present on admission or not? → U (Unknown)
2. What does the CPT modifier -25 indicate? → Significant, separately identifiable E/M service on the same day as a procedure
3. What is a deductible in health insurance? → The annual amount a patient pays out-of-pocket before insurance begins covering costs
4. The term 'bilateral' in a procedure code indicates the procedure was performed on: → Both sides of the body
5. The suffix '-ology' means: → Study of
6. Which of the following is an example of a 'technical safeguard' under the HIPAA Security Rule? → Implementing unique user IDs and password requirements for EHR access.
7. Which HCPCS Level II code series is designated for durable medical equipment (DME) such as wheelchairs and hospital beds? → E codes
8. What should a billing specialist do if they discover a significant billing error that could affect reimbursement? → Notify the insurance company immediately about the error and request an adjustment
9. What does ICD-10-PCS stand for, and where is it used? → ICD-10 Procedure Coding System, used for inpatient hospital procedures
10. A physician performs a diagnostic colonoscopy that becomes therapeutic when a polyp is removed. How should this be coded? → Code only the therapeutic colonoscopy
11. A payer denies a prior authorization request as 'not medically necessary.' What is the next appropriate step? → File an appeal with additional supporting documentation
12. Medicare uses which system to pay physicians for their professional services? → Resource-Based Relative Value Scale (RBRVS) via MPFS
13. What is the typical payment structure for providers in an HMO? → Capitation
14. In medical documentation, 'acute' vs. 'chronic' affects ICD-10-CM coding because: → They have different code assignments
15. A patient calls requesting a copy of their medical records. Under HIPAA, the covered entity must provide access within: → 30 calendar days (with a possible 30-day extension)
16. In CPT, what does the term 'bundling' refer to? → Including multiple related services within one procedure code
17. In EHR systems, what does 'copy and paste' documentation create risk for? → Propagation of inaccurate or outdated information through the record
18. A patient's insurance card shows a group number and member ID. What is the group number used for? → Identifying the employer-sponsored plan
19. Which federal agency oversees healthcare fraud and abuse compliance for Medicare and Medicaid? → The Office of Inspector General (OIG) of HHS
20. What does the term 'downcoding' mean? → Assigning a lower-level code than documentation supports
21. What does the term 'data integrity' mean in the context of EHRs? → The accuracy, completeness, and consistency of health data over its lifecycle
22. What is the purpose of an audit trail in an EHR system? → To track who accessed or modified a patient record and when
23. What is the consequence of billing for a service that required prior authorization but was not obtained? → The claim will likely be denied, and the provider may not be able to bill the patient
24. What does the 837P electronic transaction format represent? → Electronic claim transaction for professional (physician) services submitted to payers
25. Under HIPAA, which of the following is a covered entity? → A health plan that pays for medical services
26. A physician orders a hemoglobin A1c test for a diabetic patient's routine monitoring. What code set is used to report this lab service? → CPT (85018 or 83036)
27. When a surgeon performs an arthroscopic knee procedure, which CPT code range applies? → 29800–29999
28. Which of the following is a primary consequence of failing to verify insurance eligibility prior to a patient visit? → An increased risk of claim denials and revenue loss.
29. Which anatomical term describes a position closer to the point of attachment to the trunk? → Proximal
30. Which HCPCS modifier should be appended to indicate the professional component of a diagnostic radiology service? → 26