10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
These 10 free CMCB questions are organized by exam domain, so you can see how each part of the Nationally Certified Medical Coder and Biller (CMCB) blueprint is tested. Reveal the answer and explanation under each question.
A patient stays overnight in hospital observation for cough and fever. No inpatient admission occurs. At discharge, the physician documents 'cough and fever; probable pneumonia' and prescribes an antibiotic. The completed record contains no confirmed diagnosis of pneumonia. How should the diagnosis reporting reflect this encounter?
Correct answer: B - Report the documented cough and fever without coding pneumonia.
At an appointment for a scheduled knee injection, an established patient reports new wrist pain after a fall. The physician performs and documents a medically necessary wrist evaluation beyond the work required for the injection, then provides the injection as planned. No postoperative global period applies. To report the separate office E/M service, which modifier belongs on the E/M code?
Correct answer: C - 25
After misreading a medication label, a parent accidentally gives a 7-year-old twice the prescribed dose. The emergency physician documents vomiting caused by the accidental overdose and treats the child. For the medication event, which classification and diagnosis sequence are appropriate?
Correct answer: C - Accidental poisoning; report the poisoning before the vomiting.
An established patient's rheumatology visit addresses a nonsevere exacerbation of rheumatoid arthritis. The physician continues drug therapy requiring intensive laboratory monitoring for toxicity and orders two unique laboratory panels. No other data review, independent interpretation, or external discussion contributes to medical decision making. The illness does not threaten life or bodily function. The office visit is selected by MDM rather than time. Which overall MDM level applies?
Correct answer: D - Moderate
For one covered in-network service, a commercial insurer allows $300 of the $480 charge. The patient has $60 of deductible remaining, followed by 20% coinsurance, and already paid $40 toward this service. The contract requires adjustment of charges above the allowed amount. No copay or secondary insurance applies, and the annual out-of-pocket maximum will not be reached. After adjudication, what amount remains to be collected from the patient?
Correct answer: D - $68
An electronic claim file receives a 999 acceptance. The payer's subsequent 277CA rejects one claim because the rendering provider's NPI is missing; that claim has not entered adjudication. The correct NPI is available in the practice's enrollment records. What should the biller do with this claim?
Correct answer: A - Add the rendering NPI and resubmit the rejected claim as an original submission, not a replacement.
An Original Medicare beneficiary had active Qualified Medicare Beneficiary (QMB) status on the service date. After Medicare pays a covered physician claim, the practice's billing system places $38 of coinsurance in the patient balance. The state Medicaid program processes the secondary claim but pays $0 under its payment limits. How should the practice handle the $38?
Correct answer: A - Keep the $38 off the beneficiary's bill; QMB cost-sharing protection still applies.
A health plan requests the operative and pathology reports needed to review payment for a surgery. The practice has verified the requester and confirmed that both reports are relevant. The records contain no specially protected information, and no additional legal restriction applies. A clerk proposes delaying the response until the patient signs a separate HIPAA authorization. Which response is appropriate?
Correct answer: D - Send the relevant reports securely; HIPAA does not require a separate authorization here.
An operative report lists 'laparoscopic cholecystectomy' for 'cholelithiasis without cholecystitis.' Which abstract preserves both the procedure and the documented condition?
Correct answer: A - Gallbladder removed for gallstones, without documented inflammation.
A 16-year-old's growth record shows a BMI of 31.2 kg/m² at the 97th percentile for age and sex. The BMI is 108% of the age- and sex-specific 95th-percentile value. When interpreting this screening measurement, which classification is supported?
Correct answer: B - Obesity; the percentile meets pediatric obesity criteria, but the supplied measurements do not establish severe obesity.
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