Free practice test

Medical Billing and Coding Specialist Practice Test

Check what you know about the medical billing and coding specialist job with 15 free questions and instant explanations.

Updated By the Career Education Institute Curriculum Team
About this practice test

15 multiple-choice questions on medical billing and coding specialist knowledge, safety and vocabulary. Submit to see your score and explanations, or open any question’s answer as you go. Nothing is saved or shared.

Question 1 of 15Which code set is used for diagnoses in the U.S.?
Show answer

Answer: ICD-10-CM. ICD-10-CM is the U.S. diagnosis code set.

Question 2 of 15Before assigning a code found in the Alphabetic Index, you should:
Show answer

Answer: Verify it in the Tabular List. Always verify codes in the Tabular List.

Question 3 of 15What is a clean claim?
Show answer

Answer: A claim accepted and processed without errors on first submission. Clean claims process on the first pass.

Question 4 of 15The CMS-1500 form is used for:
Show answer

Answer: Professional (physician) services. CMS-1500 is the professional claim form.

Question 5 of 15Upcoding means:
Show answer

Answer: Billing a higher-level service than documented. Upcoding is billing for more than was documented and can be fraud.

Question 6 of 15Which term matches this definition: “A company that checks and forwards electronic claims to insurers.”
Show answer

Answer: Clearinghouse. Clearinghouse: A company that checks and forwards electronic claims to insurers.

Question 7 of 15What does “ICD-10-CM” mean?
Show answer

Answer: The diagnosis coding system used in the U.S. for all healthcare settings.. ICD-10-CM: The diagnosis coding system used in the U.S. for all healthcare settings.

Question 8 of 15Which term matches this definition: “Explanation of benefits / electronic remittance advice: the payer’s explanation of what was paid and why.”
Show answer

Answer: EOB / ERA. EOB / ERA: Explanation of benefits / electronic remittance advice: the payer’s explanation of what was paid and why.

Question 9 of 15What does “Modifier” mean?
Show answer

Answer: A two-character code added to a CPT or HCPCS code to give more information, such as -25 or -59.. Modifier: A two-character code added to a CPT or HCPCS code to give more information, such as -25 or -59.

Question 10 of 15Which term matches this definition: “National Correct Coding Initiative rules that prevent improper code combinations.”
Show answer

Answer: NCCI edits. NCCI edits: National Correct Coding Initiative rules that prevent improper code combinations.

Question 11 of 15What does “HCPCS Level II” mean?
Show answer

Answer: Codes for supplies, equipment, drugs and services not in CPT, such as ambulance services.. HCPCS Level II: Codes for supplies, equipment, drugs and services not in CPT, such as ambulance services.

Question 12 of 15Which term matches this definition: “A payer’s refusal to pay a claim, which may be corrected and resubmitted or appealed.”
Show answer

Answer: Denial. Denial: A payer’s refusal to pay a claim, which may be corrected and resubmitted or appealed.

Question 13 of 15What does “Revenue cycle” mean?
Show answer

Answer: The full process from patient registration to final payment.. Revenue cycle: The full process from patient registration to final payment.

Question 14 of 15Which term matches this definition: “Evaluation and management codes for office visits and other patient encounters.”
Show answer

Answer: E/M coding. E/M coding: Evaluation and management codes for office visits and other patient encounters.

Question 15 of 15What does “CMS-1500” mean?
Show answer

Answer: The standard claim form for professional (physician) services.. CMS-1500: The standard claim form for professional (physician) services.

How to study

View training