CBCS CBCS Full Exam Simulation

Question 1

A patient is seen in the emergency department for chest pain. No definitive diagnosis is established. For outpatient coding, what is the correct approach?

Accepted Answer

Code the sign or symptom of chest pain (R07.9)

Answer

Code the suspected diagnosis of myocardial infarction

Answer

Code the principal diagnosis as 'unknown'

Answer

Leave the diagnosis blank until the patient returns for follow-up

Question 2

Medicare uses which system to pay physicians for their professional services?

Accepted Answer

Resource-Based Relative Value Scale (RBRVS) via MPFS

Answer

DRG-based prospective payment

Answer

Medicare Physician Fee Schedule (MPFS)

Answer

Ambulatory Payment Classifications (APCs)

Question 3

A billing specialist discovers that a claim was submitted with an incorrect CPT code. The claim has already been paid. What is the correct action?

Accepted Answer

Submit a corrected claim or refund the overpayment to the payer

Answer

Do nothing since the claim was already paid

Answer

Write off the difference as a billing adjustment

Answer

Re-bill with the correct code without notifying the payer of the error

Question 4

What information is required on a CMS-1500 claim form in Box 21?

Accepted Answer

Diagnosis codes (ICD-10-CM codes)

Answer

Procedure codes and charges

Answer

Provider NPI number

Answer

Patient's date of birth and sex

Question 5

What does HIPAA require regarding the transmission of electronic claims?

Accepted Answer

Covered entities must use standardized transaction formats (X12 837) for electronic claims submission

Answer

All claims must be submitted on paper to ensure accuracy

Answer

Electronic claims are optional and can be submitted in any format the payer accepts

Answer

Electronic claims must be submitted through a government clearinghouse only

Question 6

Which of the following is a compliance risk related to the False Claims Act?

Accepted Answer

Knowingly submitting a claim for services not rendered or medically unnecessary

Answer

Submitting a claim one day past the filing deadline

Answer

Using an outdated CPT code edition for a current-year claim

Answer

Failing to obtain a prior authorization for a non-covered service

Question 7

A physician orders a hemoglobin A1c test for a diabetic patient's routine monitoring. What code set is used to report this lab service?

Accepted Answer

CPT (85018 or 83036)

Answer

ICD-10-PCS

Answer

HCPCS Level II

Answer

Revenue codes

Question 8

What is a Remittance Advice (RA), and how is it used in medical billing?

Accepted Answer

An electronic or paper document sent by the payer explaining claim payment or denial details

Answer

A patient's statement of benefits sent after a claim is processed

Answer

A pre-authorization confirmation number

Answer

A billing report generated by the practice management system