Free NHA CBCS practice questions with answers

Twenty-five original, source-verified NHA CBCS questions with full answers and rationale below, free to read, no account required. A new set every day.

1. Question 1

   What is the function of an HCPCS modifier?

   • It provides extra information or describes a special circumstance without changing the code's own descriptionCorrect
   • It is used only alongside Category III CPT codes, never with any HCPCS code
   • It replaces the need for a Special Report whenever an unlisted procedure code is used instead
   • It permanently and completely changes the description of the code it is attached to

   Why: An HCPCS modifier adds extra context or flags a special circumstance while leaving the underlying code's own description unchanged. Claiming it changes the code's description directly contradicts how modifiers function. HCPCS modifiers are not restricted to Category III CPT codes; HCPCS is its own separate code set. A modifier does not substitute for the Special Report an unlisted procedure code still requires. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 14, PDF p. 23.

2. Question 2

   After an insurance company's payment on a claim has been posted to a patient's account, and a balance still remains, what should the office do next?

   • Resubmit the same claim to the insurance company a second time.
   • Mail a statement to the patient for the remaining outstanding balance.Correct
   • Wait until the following year to bill the patient for the balance.
   • Write off the remaining balance automatically without contacting the patient.

   Why: Once an insurance payment has been posted to a patient's account, the office should mail a statement to the patient for whatever balance remains after that payment. Writing off the balance automatically skips billing the patient for an amount they may still owe. Waiting an entire year to bill delays collecting money the practice is owed for no stated reason. Resubmitting the same claim to the insurer does not address a remaining patient balance, since the payer has already processed and paid that claim. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 15, PDF p. 2.

3. Question 3

   A patient stops making payments on an agreed installment plan for services already provided, without any legitimate legal reason for not paying. What does this situation represent?

   • Assumption of risk
   • Breach of contractCorrect
   • Nonfeasance
   • Respondeat superior

   Why: A breach of contract occurs when a party fails to fulfill the terms of a contract without a legitimate legal reason, and a payment contract with a patient is one setting where this can happen. Respondeat superior concerns an employer's liability for an employee's conduct, not a failure to pay under an agreement. Nonfeasance and assumption of risk are negligence-related concepts describing an omitted legal duty or a defense to injury claims, neither of which describes an unpaid payment plan. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 3, PDF p. 7.

4. Question 4

   In healthcare practice bookkeeping, what does the term accounts receivable (A/R) refer to?

   • The practice's total annual revenue
   • Money already collected and deposited into the bank
   • Money the practice has billed for but not yet collectedCorrect
   • Debt the practice owes to its vendors

   Why: Accounts receivable is the running total of billed amounts the practice is still waiting to collect. Money already deposited into the bank is no longer outstanding, so it would not fall under this category. Debt the practice owes to vendors moves in the opposite direction, and total annual revenue is a broader figure than the specific uncollected balances this term tracks. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 16, PDF p. 1.

5. Question 5

   A committee made up of healthcare professionals reviews an individual patient's case specifically to determine whether the ordered services are medically necessary. What is this committee called?

   • Credentialing committee
   • Preventive care task force
   • Coordination of benefits panel
   • Utilization review committeeCorrect

   Why: A utilization review committee's specific role is reviewing an individual case to confirm that the medical care ordered is truly necessary. A credentialing committee instead evaluates a provider's qualifications for network participation, not a specific patient's case. A preventive services task force, such as the USPSTF, issues population screening recommendations; it does not review individual cases for medical necessity. A coordination of benefits panel would resolve how multiple payers split a claim, not judge medical necessity. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 12, PDF p. 9.

6. You have seen 5 of 25. Create a free account for scored practice, timing, and the full bank of 239 questions for this exam.

   Create a free account →

7. Question 6

   A coder finds an Excludes1 note beneath a diagnosis code. What does this note mean?

   • The excluded condition applies only when the patient is a minor
   • The two conditions are mutually exclusive and are generally not reported togetherCorrect
   • The excluded condition may still be coded along with this code if the patient genuinely has both
   • The excluded condition must always be sequenced before this code, not omitted

   Why: An Excludes1 note is a firm "not coded here" instruction: the two conditions are mutually exclusive, so they are generally not reported together. The guidelines allow one exception, when the two conditions are unrelated to each other, in which case both may be coded. Freely coding both whenever the patient has both describes an Excludes2 note, not Excludes1. The note concerns exclusion, not sequencing order, and nothing in the Excludes1 convention limits it to a particular age group. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 13, PDF p. 5.

8. Question 7

   When a patient's record documents both hypertension and chronic kidney disease, how does ICD-10-CM treat the relationship between the two by default?

   • It classifies the combination only when the patient also has diagnosed diabetes
   • It always treats the two conditions as unrelated and codes them with entirely separate, unlinked codes
   • It presumes a cause-and-effect relationship and classifies the combination as hypertensive chronic kidney diseaseCorrect
   • It requires the provider to explicitly state a causal link before any combination code can be used

   Why: ICD-10-CM presumes that hypertension and chronic kidney disease occurring together are causally related, and it classifies the combination as hypertensive chronic kidney disease without the provider having to spell out the link. The guidelines likewise presume a link between hypertension and heart disease unless the documentation states they are unrelated. Requiring an explicit statement of causation is the opposite of what this presumption does. Treating the two conditions as always unrelated ignores the presumed relationship entirely, and diabetes is not a precondition for it. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 13, PDF p. 17.

9. Question 8

   How is the HCPCS code manual organized?

   • Into an Alphabetic Index and a Tabular List, similar to the CPT manualCorrect
   • Into chapters organized by insurance carrier rather than by procedure or supply type
   • Into a single numeric listing with no index at all
   • Into a table of modifiers only, with the codes themselves published separately

   Why: The HCPCS manual mirrors CPT's structure, with an Alphabetic Index used to locate terms and a Tabular List used to confirm the code. It is not a single numeric listing without any index. It is organized by procedure and supply type, not by insurance carrier. The manual includes both the codes and an appendix of modifiers together, rather than publishing modifiers as a stand-alone table with codes elsewhere. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 14, PDF p. 23.

10. Question 9

    On the CMS-1500 form, which block records the National Provider Identifier of the provider who actually performed the billed service?

    • Block 25
    • Block 33a
    • Block 24JCorrect
    • Block 17b

    Why: Block 24J, in the service-line section of the CMS-1500, is reserved for the NPI of the clinician who rendered the billed service. Block 17b instead carries the NPI of a referring provider, someone who sent the patient rather than treated them. Block 33a carries the billing provider's NPI, paired with the Block 33 billing address, which is not necessarily the NPI of the clinician who rendered a given service line. Block 25 records the provider's federal tax identification number rather than an NPI. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 15, PDF p. 8.

11. Question 10

    Which CMS-1500 block is used to report the address of the facility where the service was actually performed?

    • Block 26
    • Block 33
    • Block 24B
    • Block 32Correct

    Why: A specific block on the CMS-1500 form is designated for the address of the facility where a service was actually performed. A different, nearby block instead reports the address and phone number of the provider requesting payment, which may or may not be the same location. An earlier block records the patient's account number rather than any address. Another block uses a place-of-service code to identify the setting rather than spelling out the facility's street address. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 15, PDF p. 9.

12. Question 11

    When abstracting a diagnostic statement to find the main term for the ICD-10-CM Alphabetic Index, which of the following is generally NOT used as a main term?

    • A disease name
    • An eponym named after a person
    • An anatomical siteCorrect
    • A condition, such as a fracture or injury

    Why: Main terms in the Alphabetic Index are drawn from disease names, conditions, adjectives, nouns, and eponyms, but anatomical sites are specifically excluded from that list. A disease name, by contrast, is one of the recognized main-term categories. A condition such as a fracture or injury is likewise a valid main term. An eponym, a term named after a person, is also explicitly recognized as a main-term type. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 13, PDF p. 9.

13. Question 12

    Once a patient's account has been turned over to a collection agency, what should the healthcare office do regarding further billing statements to that patient?

    • Switch to sending statements by certified mail only
    • Stop sending statements to the patientCorrect
    • Double the amount billed on the next statement
    • Continue sending monthly statements as usual

    Why: Once an account is placed with a collection agency, the office should close it for further billing activity and stop mailing statements. Continuing to send monthly statements would work against having handed the account to the agency, since both parties billing the patient at once is what this rule is meant to prevent. Doubling the billed amount or simply switching mail methods are not part of the guidance for an account already placed with a collector. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 16, PDF p. 12.

14. Question 13

    A patient's plan combines certain features of an HMO and a PPO: she is not required to select a primary care provider, but her plan will not cover non-emergency services received outside its designated network. Which plan type is this?

    • Preferred provider organization (PPO)
    • Health maintenance organization (HMO)
    • Exclusive provider organization (EPO)Correct
    • Traditional fee-for-service plan

    Why: An EPO blends the strict network limits of an HMO, covering care outside the network only for emergencies, with the freedom of not needing an assigned primary care provider. An HMO, unlike an EPO, does require patients to choose a primary care provider. A PPO differs because it still contributes toward some out-of-network care rather than excluding it. A traditional fee-for-service plan places no network restriction on the patient at all, unlike an EPO. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 12, PDF p. 9.

15. Question 14

    A patient with no current symptoms comes in for a routine blood pressure check and a cholesterol panel as part of staying ahead of potential future health problems. How would an insurance plan most likely classify these services?

    • Elective cosmetic services
    • Emergency services
    • Rehabilitative services
    • Preventive care servicesCorrect

    Why: Screening someone with no current symptoms for early signs of a problem, such as checking blood pressure or cholesterol, is exactly the kind of proactive care that falls under a plan's preventive services. Emergency services instead address an acute, urgent threat to health, which does not describe a routine screening visit. Rehabilitative services help a patient recover function after an injury or illness, not screen a healthy patient. Elective cosmetic services address appearance rather than screening for disease risk, so they do not fit this scenario either. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 12, PDF p. 2.

16. Question 15

    Before a patient is offered a formal payment arrangement, what should the medical assistant explain to them?

    • The provider's personal salary and business overhead costs
    • Only the total balance, with no explanation of what it covers
    • Only the office's cancellation policy for missed appointments
    • The professional fees, what the charges cover, and the office's credit policiesCorrect

    Why: Before a payment arrangement is set up, the medical assistant is expected to walk the patient through the professional fees involved, what those charges actually cover, and the office's own credit policies. Giving the patient only a total balance with no explanation leaves out the context the patient needs to understand the arrangement. The provider's personal salary and overhead are internal business figures, not something explained to a patient setting up payment terms. A cancellation policy addresses missed appointments, not the fees and credit terms tied to a payment arrangement. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 16, PDF p. 4.

17. Question 16

    What best describes CPT Category II codes?

    • Temporary codes assigned only to brand-new medical technology awaiting a permanent code
    • Five-digit numeric codes used exclusively to report anesthesia services
    • Optional performance-measurement tracking codes that are not paid and never replace Category I codesCorrect
    • Mandatory codes that must be reported on every claim in place of Category I codes

    Why: Category II codes are optional supplemental codes used to track performance measures; they may be reported on a claim for quality programs such as MIPS, usually with a zero-dollar charge, but they are not paid and never substitute for Category I codes. They are never mandatory in place of Category I codes, which remain the codes that describe payable services. They are not limited to anesthesia; they describe clinical components across many services. Temporary codes for emerging technology describe Category III, a different category entirely. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 14, PDF p. 2.

18. Question 17

    A provider's office transmits insurance claims electronically. What distinguishes a direct billing submission from a clearinghouse submission?

    • Direct billing serves only government payers, while a clearinghouse serves only commercial payers.
    • Direct billing accepts only paper claims, while a clearinghouse accepts only electronic ones.
    • Direct billing sends claims straight to the carrier, while a clearinghouse acts as a go-between.Correct
    • Direct billing skips HIPAA claim-format rules, while a clearinghouse must follow them.

    Why: A direct billing arrangement lets an insurance carrier accept claims sent straight from the provider's office, with no third party in between. A clearinghouse submission instead routes claims through an intermediary that sits between the healthcare facility and the insurance company. Neither method is restricted to a single claim format or a single category of payer, and both remain subject to the same federal electronic claim-format requirements. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 15, PDF p. 4.

19. Question 18

    When wounds of more than one repair classification are treated in the same encounter, how should they generally be listed?

    • Each wound must be submitted on an entirely separate claim form from the others
    • The repairs are listed strictly in the order they happen to appear on the encounter form
    • The primary procedure reported is the more complex repair, while the simpler repair is reported second and carries a modifierCorrect
    • Only the less complicated repair is reported, since the more complicated repair is assumed to be bundled into it

    Why: When repairs of different complexity occur together, the more complicated one is reported as the primary procedure, with the less complicated one reported second and marked with a modifier. Skipping the more complicated repair and reporting only the simpler one would misrepresent the actual work performed. Nothing requires filing each wound on a separate claim form; they are reported together on the same claim. Listing order is governed by complexity, not by whatever sequence happens to appear on the encounter form. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 14, PDF p. 19.

20. Question 19

    Under ICD-10-CM guidelines, when should a coder assign a code for a sign or symptom rather than a definitive diagnosis?

    • When no definitive diagnosis has been established that accounts for the sign or symptomCorrect
    • Whenever a sign or symptom is mentioned anywhere in the record, even after a final diagnosis is documented
    • Signs and symptoms are never coded once any diagnosis appears in the chart
    • Only when the patient specifically requests that the symptom be coded

    Why: Codes for signs and symptoms are appropriate when the provider has not established a definitive diagnosis that explains them. Once a diagnosis is confirmed, symptoms that are routinely part of that disease are not coded separately, so coding every symptom mentioned anywhere in the record is wrong. Symptoms not routinely associated with the confirmed diagnosis should still be coded, which is why a blanket ban on symptom codes once any diagnosis appears is also wrong. Patient preference has no bearing on this coding decision. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 13, PDF p. 12.

21. Question 20

    Regarding the CMS-1500 as a paper claim form, which statement is accurate?

    • It has been completely replaced by the electronic 5010 format and is no longer used.
    • It is the standard paper form for professional claims, but each payer sets its own filing rules.Correct
    • Each insurance payer uses its own unique paper claim form rather than a shared standard.
    • Only Medicare accepts it; commercial insurers use entirely separate paper forms.

    Why: The CMS-1500 is the shared standard paper claim form for professional services billed by physicians and suppliers, while each payer still sets its own rules for how and when claims are filed. Its use is not limited to Medicare; commercial and government payers both recognize the form. The 5010 format governs electronic transactions, and many payers, including Medicare for all but small providers, require electronic filing, yet the paper form remains in use wherever paper claims are allowed. Payers do not each keep a unique paper claim form, although institutional claims such as hospital bills use the UB-04 instead. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 15, PDF p. 4.

22. Question 21

    A patient tries to pay their balance with a starter check, one of the blank checks a bank provides temporarily before printed checks arrive. Under a typical office check-acceptance policy, should the office accept it?

    • Yes, a starter check is treated the same as any regular personal check.
    • No, a starter check is one of the check types the office should decline.Correct
    • Yes, but only if the patient also shows a second form of payment.
    • No, but only because starter checks are always postdated.

    Why: Many offices list starter checks among the checks they decline, a common precaution rather than a legal rule, because a starter check usually lacks the preprinted name and address staff would use to verify the account holder. Treating it the same as an ordinary personal check skips that verification concern. Requiring a second form of payment is not how such policies handle it; the check is simply declined. Starter checks are not always postdated, and postdating is a separate issue from the type of check. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 16, PDF p. 6.

23. Question 22

    A patient breaks her leg in a skiing accident unrelated to her job and cannot work while she recovers. Her policy begins paying income replacement soon after the injury but for only a limited number of weeks before those particular benefits end. Which category of disability coverage is paying these initial benefits?

    • Workers' compensation
    • Liability insurance
    • Long-term disability insurance
    • Short-term disability insuranceCorrect

    Why: Short-term disability coverage is designed to respond fairly quickly after a non-work-related disabling event and pays out only for a limited stretch of time, matching an initial recovery period like this one. Long-term disability instead only begins once short-term benefits run out, so it would not be the coverage paying at this early stage. Workers' compensation applies specifically to job-related injuries, and a ski accident away from work does not qualify. Liability insurance covers harm the insured causes to someone else, not the policyholder's own recovery income. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 12, PDF p. 11.

24. Question 23

    A patient is facing a financial hardship and the provider is considering adjusting or canceling a fee. What should happen before that decision is made?

    • A frank discussion with the patient about their financial situation, addressed in advance.Correct
    • The fee should be canceled automatically without discussing it with the patient.
    • The decision should be made without any conversation, based on the account balance alone.
    • The account should be sent to collections before any fee adjustment is considered.

    Why: Before adjusting or canceling a fee for a hardship case, the provider or medical assistant should have a frank, direct conversation with the patient about their financial situation, and the fee should be discussed in advance rather than decided afterward. Canceling the fee automatically without any conversation skips the direct discussion this situation calls for. Sending the account to collections works against resolving a hardship case through discussion rather than escalation. Deciding based on the account balance alone, with no conversation at all, does not reflect the guidance for handling a hardship case. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 16, PDF p. 5.

25. Question 24

    A biller is verifying insurance for a 45-year-old patient who has end-stage renal disease (ESRD) but is not otherwise disabled or elderly. Could this patient qualify for Medicare based on this diagnosis alone?

    • Yes, because Medicare covers patients diagnosed with end-stage renal disease regardless of ageCorrect
    • No, because ESRD patients must instead be covered exclusively through Medicaid
    • No, because Medicare coverage always requires the patient to be at least 65 years old
    • No, because Medicare only covers patients who qualify through a disability determination

    Why: Medicare's eligibility rules extend coverage to patients with end-stage renal disease as one of three qualifying paths, alongside reaching the minimum age and qualifying through disability, so age alone does not block this patient from coverage. Requiring every beneficiary to be at least 65 ignores the disability and ESRD pathways entirely. Disability determination is a separate qualifying path from an ESRD diagnosis, so saying only disability qualifies is also incorrect. Medicaid is a distinct, separate program, and an ESRD diagnosis does not route a patient there instead of Medicare. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 12, PDF p. 3.

26. Question 25

    Which of the following is one of the different types of banks a healthcare facility might choose to use for its accounts?

    • A claims clearinghouse
    • A patient's guarantor
    • A credit unionCorrect
    • A collection agency

    Why: A credit union is one of the types of banking institutions a healthcare facility can choose among, along with retail banks, commercial banks, and online banks. A collection agency instead pursues unpaid patient balances, and a claims clearinghouse routes electronic insurance claims, neither of which is a type of bank. A guarantor is the person responsible for a patient account, which is also not a banking institution. Primary reference: Kinn's The Medical Assistant, 15th Edition, Chapter 16, PDF p. 18.