Administrative Assisting — practice questions

8% of the exam ≈12 real questions 12 free questions here

12 scored items. Scheduling, the electronic health record, coding basics and insurance mechanics. You are not being tested as a coder — you are being tested on the front-office workflow around coding.

Where people lose points

• ICD-10-CM codes the diagnosis; CPT codes the procedure. Reversing them is the most common coding error on the exam.
• An EHR error is corrected, never erased. The original entry must remain visible with the correction attributed and dated.
• Copay, coinsurance and deductible are three different mechanisms, and questions often make you compute the patient's share.
• Verifying eligibility happens before the visit. Discovering a coverage problem at checkout is the failure the question is describing.
• Scheduling questions are really triage questions — the right answer depends on clinical urgency, not on who called first.

Questions and answers, explained

All 10 questions above, with the correct answer and why it is correct. Everything here is on administrative assisting.

1. A patient calls the clinic and says he has had crushing chest pressure and shortness of breath for the past 20 minutes. Following office triage protocol, what should the medical assistant do?

   • AOffer the first available same-day appointment and tell him to come in
   • BTake a message and route it to the provider's nurse for a callback within the hour
   • CInstruct the caller to hang up and call 911, then notify the provider immediatelyCorrect
   • DAsk a series of questions to determine whether the pain is cardiac or muscular

   Why: Chest pressure with shortness of breath is a possible acute coronary syndrome, the highest urgency category in any telephone screening protocol: direct the caller to activate EMS, then notify the provider and document the call. The closest distractor, offering a same-day appointment, has the patient travel by private car and delays defibrillation capability. Deciding whether the pain is cardiac or muscular (D) is diagnosis, outside the medical assistant's scope of practice.

   Reference Domain 5, 5C and k171; NHA test plan appointment prioritization, AHA acute coronary syndrome recognition

2. A caller who has never been seen by the practice wants an appointment for a routine physical. What is the most appropriate action?

   • ABook the standard 15-minute follow-up slot to keep the schedule moving
   • BSchedule an extended new-patient slot and collect demographic and insurance information before the visitCorrect
   • CSchedule the visit and collect all information at check-in on the day of the appointment
   • DRefer the caller to urgent care, since a physical is not an urgent need

   Why: New-patient visits need a longer slot for the full history, consents, and records review, and pre-visit collection of demographics and insurance is what allows eligibility to be verified before the patient arrives. The closest distractor, collecting everything at check-in, still books the visit but leaves no time to verify coverage or obtain any needed authorization, which is a common cause of denied claims and unhappy patients.

   Reference Domain 5, 5B and k170, k173; NHA test plan types of office visits

3. On a claim, which code set reports the patient's diagnosis — the reason the service was provided?

   • ACPT
   • BHCPCS Level II
   • CICD-10-CMCorrect
   • DNDC

   Why: ICD-10-CM codes report diagnoses, symptoms, and conditions and establish the medical necessity for the services billed. The closest distractor, CPT, reports what was done rather than why; a clean claim generally needs both, with each service code linked to a supporting diagnosis code. HCPCS Level II covers supplies, drugs, and durable medical equipment, and NDC identifies a specific drug product.

   Reference Domain 5, 5G and k184; CMS overview of coding and classification systems

4. A patient's insurance card lists "$30 office visit," and she pays that fixed amount at check-in for every visit. What is this amount called?

   • ADeductible
   • BCoinsurance
   • CPremium
   • DCopaymentCorrect

   Why: A copayment is a fixed dollar amount the patient pays for a covered service, typically collected at the time of service. The closest distractor, coinsurance, is also patient cost sharing but is a percentage of the allowed charge rather than a flat dollar amount. The deductible (A) is the annual amount the patient must pay before the plan begins paying, and the premium (C) is the recurring cost of the coverage itself.

   Reference Domain 5, 5E and k182; HealthCare.gov/CMS health insurance glossary

5. A provider orders an MRI, and the patient's plan requires the payer to approve the imaging before it is performed. What must the medical assistant do?

   • AObtain prior authorization from the payer before the MRI is scheduledCorrect
   • BSchedule the MRI and submit a primary care referral number with the claim
   • CHave the patient sign an ABN and then schedule the MRI
   • DFile a provider letter of medical necessity in the chart and schedule the MRI

   Why: Prior authorization is the payer's advance determination that a service meets its coverage and medical-necessity criteria; performing the service first commonly results in denial and a balance the practice may not be able to collect. The closest distractor, a referral, is the primary care provider's clinical authorization for the patient to see a specialist and is not the same as payer approval. An ABN (C) applies to Original Medicare beneficiaries, not to commercial prior authorization.

   Reference Domain 5, 5H and k183; CMS prior authorization requirements

6. While restocking, a medical assistant finds that the quantity of a supply on hand has fallen below the level the practice set as its reorder point. What should she do?

   • ARotate the stock so shortest expiration dates are used first, and reorder to parCorrect
   • BWait until the very last box is opened before placing a reorder
   • CMove the item to a different storage room and note the new location
   • DOrder a full year’s supply all at once in order to reduce the number of orders placed

   Why: The par level is the minimum quantity that must be on hand; when stock reaches the reorder point, the item is reordered and existing stock is rotated first-in, first-out so nothing expires on the shelf. The closest distractor, waiting until the last box is opened, risks running out mid-clinic since orders take days to arrive. Over-ordering (D) ties up money and produces expired supplies that must be discarded.

   Reference Domain 5, 5T and k191; NHA test plan inventory and supply management

7. A caller was last seen four years ago by a physician of this same specialty in this same group. Under CPT rules, which statement correctly classifies her for today's office visit and gives the right reason?

   • ANew, because no professional service was provided within the past three years.Correct
   • BEstablished, because the practice already has a chart and demographics on file.
   • CNew, because more than one calendar year has passed since her last office visit.
   • DEstablished, because she was seen by a physician in this same group practice.

   Why: CPT defines a new patient as one who has not received any professional service from the physician or qualified health professional, or from another of the exact same specialty and subspecialty in the same group practice, within the past three years. Four years is outside that window, so the visit is reported as new patient, and scheduling should give her the longer new-patient slot with demographics and insurance re-collected. An existing chart does not make a patient established, and the group relationship only matters inside the three-year window. Landing on the same classification by way of a one-year rule is still incorrect, because CPT sets no such threshold.

   Reference AMA CPT Evaluation and Management guidelines, new versus established patient three-year rule; NHA CCMA Detailed Test Plan Domain 5, task 5B, k170

8. A patient reports a new sulfa allergy. Why should the medical assistant enter it in the EHR's allergy field rather than typing it into the note?

   • AFree-text notes cannot be printed or released with a records request.
   • BOnly entries in coded fields are admissible if the chart is subpoenaed.
   • CThe allergy field is the only part of the chart the provider will read.
   • DOnly the coded allergy field triggers the drug interaction alert at order entry.Correct

   Why: Clinical decision support acts only on discrete, coded data. An allergy typed into narrative text is invisible to the drug-allergy interaction checker, does not appear on the allergy list, the medication reconciliation screen, or the summary of care record sent to another provider, so the safety net never fires. Free text is still fully part of the legal record: it is printed, released, and discoverable like anything else, and providers read the note. The single difference that matters here is that only the structured field can be acted on automatically.

   Reference ASTP/ONC Health IT Certification Program criteria, 45 CFR 170.315(a)(4) drug-allergy interaction checks and 170.315(a)(9) clinical decision support; NHA CCMA Detailed Test Plan Domain 5, task 5R, k190 (data entry and data fields)

9. Before a scheduled video visit begins, which step best prepares the office for the connection dropping mid-visit?

   • AAsk the patient to keep a second device logged in as a spare backup screen.
   • BTell the patient to refresh the browser if the video freezes at all.
   • CConfirm the patient's current location and a working call-back number.Correct
   • DNote the visit as telehealth so it can be rescheduled if it drops out.

   Why: The pre-visit check establishes who is on the call, where the patient physically is, and a phone number that reaches her. Location drives which state's licensure applies and, far more urgently, tells the office where to send emergency services if the patient deteriorates on camera. The call-back number is what lets the encounter continue by telephone, the standard fallback when video fails. A spare device and a browser refresh are reasonable tips but neither keeps the visit going when the network itself drops, and coding the visit type changes nothing at the moment contact is lost.

   Reference NHA CCMA Detailed Test Plan Domain 5, task 5V, k192 (telehealth technologies and barriers to access); telehealth.hhs.gov guidance on verifying patient location and emergency planning before a virtual visit; state licensure applies where the patient is located at the time of service

10. Which part of Medicare covers the physician office visits and outpatient services this practice bills?

    • APart A, which covers inpatient hospital stays and skilled nursing care.
    • BPart B, which covers outpatient, physician, and preventive services.Correct
    • CPart C, under which a private plan replaces the drug benefit only.
    • DPart D, which covers outpatient visits and self-administered drugs.

    Why: Part A is hospital insurance and pays for inpatient stays, skilled nursing facility care, hospice, and some home health. Part B is medical insurance and covers physician and outpatient services, preventive services, durable medical equipment, and most drugs administered in the clinic, which is what a medical office bills. Part C, Medicare Advantage, is a private plan that delivers the Part A and Part B benefits and usually drug coverage too, so it is not a drug-only replacement. Part D is outpatient prescription drug coverage and pays nothing toward an office visit.

    Reference CMS Medicare program structure, Parts A through D; NHA CCMA Detailed Test Plan Domain 5, task 5E, k181 (insurance fundamentals)

Topics inside this domain

• Correcting an error in the medical record
• HIPAA disclosures and minimum necessary
• Informed vs implied consent, and who obtains it
• Specimen labeling and patient identification

Drill other domains

• Foundational Knowledge and Basic Science (10%)
• Anatomy and Physiology (5.3%)
• Patient Intake and Vitals (9.3%)
• General Patient Care (18.7%)
• Infection Control and Safety (10%)
• Point of Care Testing and Laboratory Procedures (6%)

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