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Medical Billing And Coding Vocab
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medical-transcription
Instructions:
Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
-51 - Multiple Procedures
Full ROM
Hypertension Table
Unspecified nature
2. contains errors or omissions. Usually - these claims do not pass front-end edits. They are either processed manually for resolving problems - or rejected for payment.
Dirty claim
premium
Long bones
Pathologic
3. Produce secretions that allow the body to be moisturized or cooled.
Paper Claim
sebaceous(oil) glands and the suddoriferous (sweat) glands
MEDICAID COVERAGE
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
4. This modifier is used to report a procedure or service that has more than one Modifier but the third-party payer does not allow the addition of multiple modifiers to the code. Modifier -99 is attached to the procedure code and the multiple Modifiers
upper appendicular skeleton
-99 - Multiple Modifiers
Fee Schedule
Established Patient
5. Prescription Drugs The Medicare Prescription Drug - Improvement - and Modernization Act enacted in December 2003 and began implementation in January 2006 where Medicare beneficiaries can enroll in the Medicare prescription drug plan. The beneficiari
Hypertension Table
MEDICARE Part D
Fissure
Chief complaint
6. Upper jaw bone
bullet (a
appendicular skeleton .
Maxilla
Ethmoid Bone
7. Mild or controlled hypertension and no damage to the vascular system or organs.
Benign (hypertension)
Full ROM
Accident
Vomer
8. Is the federal government's health insurance program created by the Social Security Act of 1965 titled 'Health Insurance for the Aged and Disabled'. It is administered by the Centers for Medicare and Medicaid Services (CMS) - formerly known as Health
sebaceous(oil) glands and the suddoriferous (sweat) glands
Deductible
Medicare
Medically needy
9. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
The Good Samaritan Act
stand-alone codes
Fissure
triangle (a
10. poisoning was inflicted by another person with intent to kill or injure
CPT SECTIONS.
Assault
Non-covered benefit
The Integumentary System
11. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
Remittance Advice
Carpals
Health Insurance Portability and Accountability Act (HIPAA)
Occipital Bone
12. is one who has not received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years.
New patient
triangle (a
There are three layers to the skin
Alphabetic Index (Volume 2)
13. Is a statement of the patient's account history - showing dates of service - detailed charges - payments (i.e. deductibles and co-pays) - the date the insurance claim was submitted - applicable adjustments and account balance.
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
There are two types of sweat glands
itemized statement
Limited ROM
14. forms the two lower sides of the cranium.
HCPCS Level II codes (National Codes)
Chief complaint (CC)
Temporal Bone
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
15. Are located in the dermal layer of the skin over the entire body - except for the palms of the hands and soles of the feet. The sebaceous glands secrete an oily substance called sebum. Sebum contains lipids that help lubricate the skin and minimize w
lunula
Uncertain behavior
No ROM
Sebaceous glands
16. The reason the patient came to see the physician.
Relative Value Payment Schedules Method
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Chief complaint (CC)
Fiscal Intermediary
17. The physician must obtain this number in order to practice within a state.
State License Number
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Complicated
Performing Provider Identification Number (PPIN)
18. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Coding
There are two types of sweat glands
Mandible
Medical necessity
19. make up part of the roof of the mouth
Pelvis
Palatine bones
Medical Records
appendicular skeleton .
20. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.
Lipocyte
Limited ROM
stand-alone codes
encounter form
21. The E&M section includes codes that pertain to the nature of the physicians' work. The codes depend on type of service - patient status - and place where service was rendered. The E&M section is divided into broad categories such as office visits - h
Alopecia
Evaluation and Management Review
Alphabetic Index (Volume 2)
Vomer
22. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
Fraud
Disability insurance
Employer Identification Number (EIN)
Rib Cage
23. Contain the full description of the procedure for the code indented codes: these are codes listed under associated stand-alone codes. To complete the description for indented codes - one must refer to the portion of the stand alone code description b
lunula
Secondary malignancy
Spinal/Vertebral Column
stand-alone codes
24. .. lower jaw bone.
Mandible
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Vomer
Category III Codes CPT
25. A fat cell
Benign (hypertension)
Lacrimal bones
Lipocyte
Palatine bones
26. This is not specified as benign or malignant in the diagnosis or medical record.
Unspecified (hypertension)
Impetigo
Consultation
Fissure
27. are composed of a group of three-digit categories representing a group of conditions or related conditions; they are divided into categories. e.g. . - Disorders of Thyroid Gland (240 - 246).
Sections
Fissure
Hairline
Macule
28. Provide the means by which the reporting physician can indicate that a service or procedure that has been performed has been altered by some specific circumstance but not changed in its definition or code.
Hypertension Table
Humerus
Modifiers
eponychium
29. Various terms are used to describe the state of submitted forms. The following are some of the terms that are typically used by insurance carriers.
Medicare Claim Status
Birthday rule
The Patient Care Partnership (Patient's Bill of Rights)
Relative Value Payment Schedules Method
30. Are located in the dermal layer of the skin over the entire body - except for the palms of the hands and soles of the feet. The sebaceous glands secrete an oily substance called sebum. Sebum contains lipids that help lubricate the skin and minimize w
Coding
Sebaceous glands
-26 - Professional Component
New patient
31. Is the lateral lower arm bone (in line with the thumb).
Impetigo
Advance Beneficiary Notice
Radius
Pathologic
32. Is one who has no contract with the health insurance plan.
False Claims Act (FCA)
Category II Codes CPT
Nonparticipating physician
Melanin
33. This involves the use of relative value scales which assign a relative weight to individual services according to the basis for the scale. Services that are more difficult - time consuming - or resource intensive to perform typically have higher rela
nonessential modifiers
Relative Value Payment Schedules Method
Temporal Bone
Remittance Advice
34. Lower portion of the pelvic bone
Ischium
Unique Provider Identification Number (UPIN)
Neoplasm Table
Established Patient
35. This is not specified as benign or malignant in the diagnosis or medical record.
Section 3 Index to External Causes of Injury (E codes)
Unspecified (hypertension)
Categories
phalanges (phalanx.s)
36. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Evaluation and Management Review
Coding
Birthday rule
essential modifiers
37. An insurance plan issued to an individual. Premium rates are usually higher than group rates and service availability is lessened with this type of coverage.
MEDICAID COVERAGE
Medically needy
co-payment
Personal Insurance
38. is a federal program administered by state governments to provide medical assistance to the needy. Each state sets its own guidelines for eligibility and services - therefore benefits and coverage may vary widely from state to state.
Two triangular symbols (a
Gender rule
Medicaid
Preferred Provider plan
39. The lower anterior part of the bone
Pubic bone
False Claims Act (FCA)
eponychium
Keratin
40. Are temporary codes for emerging technology - services and procedures. If a Category III code is available - it is reported instead of a Category I unlisted code.
Fissure
Category III Codes CPT
Abuse
Flat bones
41. Number assigned by the insurance company to a physician who renders services to patients.
Colles
Hairline
Consultation
Provider Identification Number (PIN)
42. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
ulna
Chief complaint
Patient Confidentiality
Hairline
43. The bones are connected to one another by fibrous bands of tissue . Muscles are attached to the bone by tendons. The fibrous covering of the muscles is called the fascia
Category I Codes CPT
Outpatient
Reasons for Documentation
ligaments
44. The CPT Index is arranged in alphabetical order by main terms which are further divided by subterms. There are five location methods: 1. Service or Procedure 2. Anatomic site 3. Condition or Disease 4. Synonym/Eponym 5. Abbreviation
Undetermined
Vomer
HCPCS Level I codes
Location Methods
45. Is a managed care benefits plan that provides a wide range of medical services to individuals that have been enrolled into the program. It is generally the least costly but at the same time also the most restrictive. This plan uses a gatekeeper physi
Medicaid
Full ROM
Clearinghouse
Health Maintenance Organization (HMO)
46. Superior and widest bone
Uncertain behavior
Impetigo
Pelvis
Chief complaint
47. Physicians are legally responsible for their own conduct and any actions of their employees (their designee) performed within the context of their employment. This is referred to as 'vicarious liability -' also known as 'respondent superior -' which
Sphenoid Bones
Employer Liability
False ribs
Humerus
48. - To pay for medical services and items that Medicare does not cover and Medicare's coinsurance and deductibles - beneficiaries may purchase a supplemental insurance. Medigap is a private insurance designed to help pay for those amounts that are typ
Nonparticipating physician
Carpals
Medigap (Medicare Supplemental Insurance)
Complicated
49. most synarthroses are immovable joints held together by fibrous tissue.
Blue Cross/Blue Shield Plans
No ROM
HCPCS Level II codes (National Codes)
MEDICARE Part B
50. are small with irregular shapes. They are found in the wrist and ankle.
Health practitioner
Outpatient
Section 3 Index to External Causes of Injury (E codes)
Short bones
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