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Quizzes > Health & Medicine

Medical Billing Quiz: Practice Claims, Codes, and Terms

20-question medical billing mcqs test with instant results and answer review.

Editorial: Review CompletedCreated By: Cherry MoradosUpdated Aug 26, 2025
Difficulty: Moderate
Grade: Grade 12
Study OutcomesCheat Sheet
Colorful paper art promoting a trivia quiz for Medical Billing Mastery practice test.

This medical billing quiz helps you practice claims, CPT and ICD‑10 basics, and EOB terms with 20 quick MCQs. Use it to check knowledge, spot gaps, and build speed. For more study, try the medical billing and coding quiz, focus on codes in the icd 10 quiz, or review shorthand in the medical abbreviation quiz.

Which form is typically used by physician offices to submit outpatient professional claims to payers in the United States?
CMS-1500 (HCFA-1500)
DS-250 inpatient ticket
DAA-1200
UB-04 (CMS-1450)
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Statement: The CMS-1500 is primarily used for facility inpatient claims.
True
False
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What does ICD-10-CM primarily code?
Procedures performed in the hospital inpatient setting
Diagnoses and conditions
Supplies and durable medical equipment
Anesthesia time units
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Which code set is most commonly used to report physician procedures and services in the outpatient setting?
CPT (Current Procedural Terminology)
LOINC
ICD-10-PCS
NDC
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What unique 10-digit identifier is used to identify healthcare providers in standard transactions?
CLIA number
NPI
TIN
DEA number
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Statement: HIPAA requires the protection of PHI, which includes a patient's diagnosis linked with their name.
True
False
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Statement: HCPCS Level II codes are alphanumeric and typically report supplies, equipment, and some services not in CPT.
True
False
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Modifier 25 appended to an E/M code indicates which of the following?
Distinct procedural service
Bilateral procedure
Increased procedural services
Significant, separately identifiable E/M service on the same day as another procedure
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A patient has a $500 deductible and has paid $200 so far this year. The allowed amount for today's covered service is $150. How much is applied to the deductible?
$300
$500
$0
$150
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What is the primary role of a clearinghouse in medical billing?
Auditing medical records for coding accuracy only
Translating and transmitting claims between providers and payers
Setting provider fee schedules
Collecting copays at the front desk
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Statement: An EDI 837 is a standard electronic claim format used to submit healthcare claims.
False
True
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Which claim form is commonly used for hospital facility billing, including inpatient and outpatient services?
OIG-990
DEA-224
CMS-1500
UB-04 (CMS-1450)
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What is balance billing in the context of in-network services?
Billing only the secondary insurance
Billing the patient for their copay only
Billing the patient for the difference between the provider charge and the payer allowed amount, beyond patient responsibility
Billing the payer for non-covered services
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The global surgical package generally includes which of the following?
Only the surgery itself, not follow-up care
Only anesthesia services
Only inpatient room and board
Pre-operative, intra-operative, and typical post-operative care within a defined period
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Which electronic remittance file format is used for payment and denial information from payers?
EDI 270/271
EDI 835
EDI 837P
EDI 276/277
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Which code set is used to report inpatient hospital procedures?
HCPCS Level II
CPT Category II
SNOMED CT
ICD-10-PCS
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Which statement best describes the birthday rule for dependent coverage?
The parent with the earliest birth date in the calendar year has the primary plan for the child
The higher-income parent is always primary
The older parent is always primary
The mother is always primary
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Statement: The Anti-Kickback Statute prohibits knowingly offering or receiving remuneration to induce referrals for items or services covered by federal healthcare programs.
False
True
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In claim status inquiries, which transaction set communicates request and response?
820/834
276/277
275/278
270/271
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Which organization publishes the National Correct Coding Initiative (NCCI) edits?
American Medical Association
Food and Drug Administration (FDA)
Office for Civil Rights (OCR)
Centers for Medicare & Medicaid Services (CMS)
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Study Outcomes

  1. Understand essential medical billing and coding principles.
  2. Identify common billing errors in medical documentation.
  3. Apply accurate billing procedures to case study scenarios.
  4. Analyze coding strategies to optimize reimbursement efficiency.
  5. Evaluate system audits to pinpoint areas for improvement.

Medical Billing Quiz & MCQs Test - QuizMaker Cheat Sheet

  1. Master CPT, ICD-10 & HCPCS - Get ready to speak the billing "language" like a pro by mastering CPT, ICD-10, and HCPCS codes! These standardized code sets are the secret sauce to accurate claim submissions and faster reimbursements.
  2. Navigate the Full Billing Workflow - From greeting your patient at registration to celebrating when the payment posts, understanding each step of the billing cycle prevents bottlenecks and claim delays. This roadmap keeps your practice humming with efficiency and happy reimbursements.
  3. Demystify Insurance Lingo - Co‑insurance, deductibles and EOBs sound like alphabet soup until you break them down. Knowing these buzzwords inside out lets you guide patients through out‑of‑pocket costs and nixes surprise bills!
  4. Champion HIPAA Compliance - Protecting patient privacy isn't just good manners - it's the law! Dive into HIPAA essentials so you can lock down sensitive info, avoid hefty fines, and keep your reputation spotless.
  5. Hone Your Coding Skills - Turning medical services into accurate codes is like cracking a puzzle - get it right and every claim fits perfectly. Strong coding chops mean cleaner documentation, fewer denials, and more time celebrating your wins.
  6. Understand Clearinghouse Magic - Clearinghouses act like quality-control agents for your claims - they review, format, and dispatch them to payers without errors. Partnering with a savvy clearinghouse slashes denials and speeds up payments!
  7. Verify Patient Eligibility - Nothing derails a claim faster than unexpected coverage gaps. Checking benefits upfront means fewer surprise rejections, smoother billing runs, and happier patients all around.
  8. Master the Appeals Process - Denials happen, but they don't have to be the end of the story. Learn how to craft solid appeal letters, gather supporting docs, and champion each claim until it's paid.
  9. Stay on Top of Code Updates - CPT and ICD codes evolve every year - skipping an update is like using yesterday's map to navigate a new city. Keep your finger on the pulse to ensure billing accuracy and compliance.
  10. Leverage Billing Technology - Modern software tools automate tedious tasks, spot errors before submission, and supercharge your workflow. Embracing tech means more time for learning, less time buried in paperwork, and a smoother billing engine!
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