200+ Free CBCS Practice Questions

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During the adjudication process, the insurance payer determines that a claim for a diagnostic MRI is missing the required prior authorization number. What will be the most likely outcome?

The claim will be pended and the payer will contact the provider for the authorization number

The claim will be paid at a reduced rate

The claim will be paid in full and a post-payment review will be initiated

The claim will be denied with a reason code indicating missing authorization

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2026 Statistics

Key Facts: CBCS Exam

125

Total Exam Items

NHA CBCS exam facts

100

Scored Items

NHA CBCS test plan

Pretest Items

NHA CBCS exam facts

3 hours

Exam Duration

NHA CBCS exam facts

390/500

Passing Score

NHA Candidate Handbook

200

Practice Questions Here

OpenExamPrep question bank

The current NHA CBCS exam has 125 total items: 100 scored items plus 25 unscored pretest items, with a 3-hour time limit and a scaled passing score of 390/500. The 100 scored items are distributed across four domains: Revenue Cycle and Regulatory Compliance (15 items), Insurance Eligibility and Other Payer Requirements (20 items), Coding and Coding Guidelines (32 items), and Billing and Reimbursement (33 items). NHA also states that, for exams on or after September 24, 2024, CBCS candidates no longer need or are permitted to bring coding manuals because needed coding information is included in the exam questions.

Sample CBCS Practice Questions

Try these sample questions to test your CBCS exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 200+ question experience with AI tutoring.

1A patient presents to their physician for an annual wellness visit. During the visit, the physician also evaluates a new complaint of persistent knee pain and orders an X-ray. How should the coder report this encounter?

A.Report only the preventive visit code since it was the primary reason for the encounter

B.Report both the preventive visit code and a separate E/M code with modifier -25 for the knee evaluation

C.Report only the E/M code for the knee evaluation since it required more medical decision-making

D.Report the preventive visit with the X-ray code only; no additional E/M is allowed

Explanation: When a significant, separately identifiable E/M service is performed during a preventive visit, both services should be reported. Modifier -25 is appended to the problem-oriented E/M code to indicate it was a distinct service from the preventive visit. The X-ray would also be coded separately.

2Under the current E/M guidelines for office and outpatient visits, what are the two methods a provider can use to select the appropriate level of service?

A.History complexity and number of diagnoses addressed

B.Physical examination detail and review of systems

C.Medical decision-making (MDM) or total time spent on the date of the encounter

D.Chief complaint severity and number of tests ordered

Explanation: Current CPT guidelines for office/outpatient E/M services (99202-99215) allow providers to select the level based on either the complexity of medical decision-making (MDM) or the total time spent on the encounter date. The older method of counting history/exam bullets was eliminated in the 2021 E/M revisions.

3A surgeon performs a laparoscopic cholecystectomy. The global surgical package for this procedure has a 90-day global period. Which of the following services would require a separate CPT code during the global period?

A.A follow-up office visit on post-operative day 14 to check the incision site

B.Removal of surgical staples at the 10-day follow-up

C.A phone call to discuss the pathology results of the removed gallbladder

D.Treatment of a urinary tract infection unrelated to the surgery on post-operative day 30

Explanation: Services included in the global surgical package include pre-operative visits (after decision for surgery), intra-operative services, and post-operative follow-up care related to the surgery. Treatment of an unrelated condition (such as a UTI) during the global period is separately reportable, typically with modifier -24 appended to the E/M code to indicate the service was unrelated to the original procedure.

4Which CPT code range is used to report Evaluation and Management (E/M) services for office and other outpatient visits?

A.99281-99285

B.99221-99223

C.99241-99245

D.99202-99215

Explanation: CPT codes 99202-99215 are used for office and other outpatient E/M services. Codes 99202-99205 are for new patients, and 99211-99215 are for established patients. Code range 99281-99285 covers emergency department visits, 99221-99223 covers initial hospital care, and 99241-99245 was formerly used for outpatient consultations.

5A provider performs a diagnostic colonoscopy and discovers a polyp, which is then removed by snare technique during the same session. How should this be coded?

A.Report both the diagnostic colonoscopy and the polypectomy codes separately

B.Report only the diagnostic colonoscopy code since the polypectomy was incidental

C.Report only the polypectomy code since it includes the diagnostic colonoscopy

D.Report the diagnostic colonoscopy with modifier -22 for the additional work

Explanation: When a diagnostic colonoscopy converts to a therapeutic procedure (such as polypectomy), only the therapeutic procedure code is reported. The colonoscopy with polypectomy code (e.g., 45385) includes the diagnostic portion of the procedure. Reporting both would constitute unbundling, which is improper coding.

6A coder notices that a provider documented a level-4 new patient office visit (99204) but only documented low-complexity medical decision-making in the note. What action should the coder take?

A.Code 99204 as the provider documented

B.Automatically downcode to 99202 since the documentation is insufficient

C.Add modifier -22 to justify the higher code level

D.Query the provider to clarify the level of service and reconcile the discrepancy

Explanation: When documentation does not support the level of service indicated by the provider, the coder should query the provider for clarification. Coders should not automatically downcode or upcode without attempting to resolve documentation discrepancies. A provider query allows the physician to amend or clarify the record, ensuring accurate code assignment.

7A patient receives a flu vaccine (administration and the vaccine itself) at their physician's office during a routine visit. How many CPT codes are typically needed to report the vaccination?

A.Two codes: one for the vaccine product and one for the administration

B.One code for the vaccine product only

C.Three codes: one for the E/M, one for the vaccine, and one for the administration

D.One code that covers both the vaccine and administration together

Explanation: Vaccine coding requires two separate CPT codes: one for the vaccine product itself (from the 90630-90749 range) and one for the immunization administration (from the 90460-90474 range). The E/M visit code would only be reported additionally if a significant, separately identifiable E/M service was also performed.

8A physician performs a procedure on both the right and left knee during the same operative session. The procedure has the same CPT code for each side. What is the correct way to report this bilateral procedure?

A.Report the CPT code once with modifier -50 (Bilateral Procedure)

B.Report the CPT code twice with no modifier

C.Report the CPT code once with modifier -59 (Distinct Procedural Service)

D.Report the CPT code once with modifier -22 (Increased Procedural Services)

Explanation: Modifier -50 indicates that a procedure was performed bilaterally (on both sides of the body) during the same operative session. Some payers may prefer the code listed twice with modifiers -RT (right) and -LT (left), but the standard CPT convention is to use modifier -50 on a single line. Modifier -59 is for distinct procedural services, and -22 is for increased complexity.

9A patient is seen in the office for management of type 2 diabetes mellitus with diabetic chronic kidney disease, stage 3. Under ICD-10-CM combination code conventions, which coding approach is correct?

A.Assign a single combination code for diabetes with kidney complications, then a separate code for the CKD stage

B.Assign separate codes for diabetes, kidney disease, and the stage individually with no combination code

C.Assign only the diabetes code since the kidney disease is assumed to be included

D.Assign only the CKD code since it is the more specific diagnosis

Explanation: ICD-10-CM provides combination codes that link diabetes with its manifestations (e.g., E11.22 for Type 2 diabetes with diabetic CKD). However, an additional code is required to specify the stage of CKD (N18.3 for stage 3). This follows the "code also" and "use additional code" instructions in the Tabular List.

10A patient presents to the emergency department after falling from a ladder at home while cleaning gutters, sustaining a fracture of the left distal radius. Which of the following is the correct sequencing of ICD-10-CM codes?

A.Fracture code first, then the external cause code, then the place of occurrence and activity codes

B.Place of occurrence first, then the fracture code, then the activity code

C.External cause code first, then the fracture code, then the place of occurrence

D.The fracture code only; external cause codes are optional and typically not required

Explanation: Per ICD-10-CM Official Guidelines, the injury code (fracture) should be sequenced first as the reason for the encounter. External cause codes (how the injury occurred, place of occurrence, and activity) are supplementary codes that provide additional information and are sequenced after the injury code. While external cause codes are not required by all payers, they are part of proper coding practice.

About the CBCS Exam

The CBCS certification validates entry-level medical billing and coding competence across the full revenue cycle: regulatory compliance, insurance eligibility, ICD-10-CM/CPT/HCPCS coding, claims submission, reimbursement, denials, appeals, and patient financial workflows.

Assessment

100 scored items + 25 pretest items

Time Limit

3 hours

Passing Score

Scaled score 390/500

Exam Fee

See current NHA store price (NHA / PSI / Live Remote Proctoring)

CBCS Exam Content Outline

15 items (15%)

Revenue Cycle and Regulatory Compliance

Revenue cycle phases, HIPAA privacy and security, HITECH, fraud and abuse indicators, OIG compliance concepts, consent, release of information, audits, and professional communication

20 items (20%)

Insurance Eligibility and Other Payer Requirements

Insurance cards and documentation, eligibility and benefits checks, payer types, coordination of benefits, referrals, prior authorization, predetermination, ABN, self-pay, and medical necessity

32 items (32%)

Coding and Coding Guidelines

Clinical documentation abstraction, ICD-10-CM, CPT, HCPCS Level II, modifiers, code sequencing, E/M logic, place of service, specialty coding, telehealth, Medicare coding requirements, and medical necessity

33 items (33%)

Billing and Reimbursement

CMS-1500 and UB-04 claim data, EDI submission, clean claims, clearinghouse rejections, remittance advice, payment posting, contractual adjustments, denials, appeals, aging reports, and collections

How to Pass the CBCS Exam

What You Need to Know

Passing score: Scaled score 390/500
Assessment: 100 scored items + 25 pretest items
Time limit: 3 hours
Exam fee: See current NHA store price

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CBCS Study Tips from Top Performers

1Study the full claim lifecycle from patient access through payment posting; many CBCS questions ask what should happen next in a workflow.

2Treat coding questions as application questions. Since manuals are not permitted, focus on guideline logic, sequencing, modifiers, medical necessity, and documentation support.

3Practice insurance eligibility scenarios until you can separate coverage, benefits, copay, deductible, coinsurance, referral, prior authorization, predetermination, and ABN issues.

4Read every remittance and denial scenario from the payer's perspective: identify the cause, determine whether correction or appeal is appropriate, and document the action.

5Use timed mixed practice, not only chapter drills, because the exam blends compliance, eligibility, coding, and reimbursement decisions.

Frequently Asked Questions

How many questions are on the CBCS exam?

The current NHA CBCS exam has 125 total items: 100 scored items plus 25 unscored pretest items. Pretest items are mixed into the exam and are not identified, so you should treat every item as scored.

How long is the CBCS exam?

The CBCS exam time limit is 3 hours. With 125 total items, that gives about 86 seconds per item, so candidates should practice both accuracy and pacing.

What score do I need to pass the CBCS exam?

NHA uses scaled scoring from 200 to 500, and the passing standard for NHA exams covered by the Candidate Handbook is a scaled score of 390 or higher. This is not the same as a raw 78% calculation.

Do CBCS candidates bring coding manuals?

No. NHA states that candidates taking the CBCS exam on or after September 24, 2024 no longer need, and are not permitted, to bring coding manuals. Necessary coding information is included within the exam questions.

What are the four CBCS exam domains?

The four scored domains are Revenue Cycle and Regulatory Compliance (15 items), Insurance Eligibility and Other Payer Requirements (20 items), Coding and Coding Guidelines (32 items), and Billing and Reimbursement (33 items).

What are the eligibility requirements for CBCS?

NHA lists a high school diploma/GED pathway, including candidates scheduled to earn it within 12 months, plus either completion of a medical billing and coding training or education program within the last 5 years or qualifying supervised work experience in the field.