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

For outpatient coding, when no definitive diagnosis is established, the sign or symptom (chest pain) is coded — not a suspected diagnosis.

Question 2

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

Accepted Answer

Resource-Based Relative Value Scale (RBRVS) via MPFS

Answer

Medicare pays physicians based on the Resource-Based Relative Value Scale (RBRVS), implemented through the Medicare Physician Fee Schedule.

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

Discovered billing errors must be corrected by submitting a corrected claim and refunding any overpayment — failing to do so can constitute fraud.

Question 4

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

Accepted Answer

Diagnosis codes (ICD-10-CM codes)

Answer

Box 21 on the CMS-1500 claim form is used to report ICD-10-CM diagnosis codes.

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

HIPAA requires covered entities to use standardized X12 transaction formats, including the 837 for electronic claims submission.

(CBCS) Certified Billing and Coding Specialist Practice Test

(CBCS) Certified Billing and Coding Specialist Practice Test

CBCS CBCS Full Exam Simulation