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Test your basic knowledge |
Medical Billing And Coding Vocab
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Study First
Subject
:
medical-transcription
Instructions:
Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can
study here
.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.
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. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
Impetigo
Pre-determination
Nonparticipating physician
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
2. Numbers 1-7 - attach directly to the sternum in the front of the body.
The Universal Claim Form
Clean claim
true ribs
Mandible
3. The skin and its accessory organs.Integument means covering. The skin covers over an area of 22 square feet ( an average adult). It is a complex system of specialized tissues containing glands - nerves and blood vessels. The main function of the skin
Reasons for Documentation
The Integumentary System
-26 - Professional Component
MEDICARE Part C
4. Is a requirement for some health insurance plans to obtain permission for a service or procedure before it is done. It indicates that a specific procedure or service is deemed 'medically necessary'.
National Correct Coding Initiative (NCCI)
Full ROM
Pre-authorization
Remittance Advice
5. forms the roof of the nasal cavity.
Review of Systems (ROS)
Medigap (Medicare Supplemental Insurance)
Ethmoid Bone
Suicide Attempt
6. most synarthroses are immovable joints held together by fibrous tissue.
Tabular List (Volume 1)...
No ROM
Rib Cage
MEDICARE Part A
7. found in the Index under the main term 'Hypertension' - and it contains a list of conditions that are due to or associated with hypertension. The table classifies the conditions as:
Multigravida
Evaluation and Management Review
Group Provider Number
Hypertension Table
8. Absence of hair from areas where it normally grows
Alopecia
HCPCS Level I codes
History of present illness (HPI)
Abuse
9. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
Primary malignancy
axial skeleton
Category II Codes CPT
MEDICARE Part C
10. Law passed by the federal government to prosecute cases of Medicaid fraud.
Nodule
Civil Monetary Penalties Law (CMPL)
Inpatient
Birthday rule
11. 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).
Physician
Sections
Sesamoid bones
phalanges (phalanx.s)
12. The spinal /vertebral column is divided into five regions from the neck to the tailbone. There are 26 bones in the spine and they are referred to as the vertebrae. The following list explains the bones of the spine: Cervical -Neck Bones -Thoracic -U
History of present illness (HPI)
Spinal/Vertebral Column
Fiscal Intermediary
Point-of-Service plan (POS)
13. This modifier is used when the same procedure is performed on a mirror-image part of the body..
-50 - Bilateral Procedure
Colles
Mandible
Explanation of Benefits (EOB)
14. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.
Unspecified nature
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Greenstick
Limited ROM
15. A fat cell
Lipocyte
Neoplasm Table
Nodule
Tabular List (Volume 1)...
16.
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Employer Identification Number (EIN)
Pre-certification
Pre-authorization
17. Includes - but is not limited to - physician assistant - certified nurse-midwife - qualified psychologist - nurse practitioner - clinical social worker - physical therapist - occupational therapist - respiratory therapist - certified registered nurse
Clean claim
Health practitioner
-90 - Reference (Outside) Laboratory
co-payment
18. Mild or controlled hypertension and no damage to the vascular system or organs.
Benign (hypertension)
Impacted
sprain
eponychium
19. solid - round or oval elevated lesion more than 1 cm in diameter
-99 - Multiple Modifiers
Outpatient
Nodule
Group practice
20. Consists of the skull - rib cage - and spine
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
HCPCS Level I codes
Preferred Provider plan
axial skeleton
21. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
Preferred Provider Organization (PPO)
Full ROM
Maxilla
Group Provider Number
22. Includes - but is not limited to - physician assistant - certified nurse-midwife - qualified psychologist - nurse practitioner - clinical social worker - physical therapist - occupational therapist - respiratory therapist - certified registered nurse
Coding
Musculoskeletal System
Health practitioner
Wheal
23. 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.
Medicaid
Pre-authorization
Unspecified nature
Hairline
24. This is also known as fee-for-service. Under this plan - the services that are paid for are listed in the policy and payments are based on the fees physicians charge for the service. Each year - the beneficiary must meet a deductible - after which -
stand-alone codes
Clean claim
Indemnity Insurance
Neoplasm Table
25. The poisoning was self-inflicted.
Suicide Attempt
-32 - Mandated Services
Frontal Bone
Mandible
26. Number assigned by the insurance company to a physician who renders services to patients.
HCPCS Level II codes (National Codes)
Provider Identification Number (PIN)
Gangrene
Group Insurance
27. is defined as one who has not received any medical services within the last three years.
New Patient
Uncertain behavior
Medicare Claim Status
-32 - Mandated Services
28. the bone is broken and the ends are driven into each other.
TRICARE
Polyp
Evaluation and Management Review
Impacted
29. 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
Unique Provider Identification Number (UPIN)
Employer Liability
Reasons for Documentation
Surgical Package
30. The fractured area of bone collapses on itself.
Compression fracture
Indemnity Insurance
Rejected claim
Lacrimal bones
31. This modifier is used when the same procedure is performed on a mirror-image part of the body..
Reasons for Documentation
-50 - Bilateral Procedure
Category I Codes CPT
Ulcermembranes
32. Groove or crack like sore
Surgical Package
Sesamoid bones
Fissure
circle with a line through it)
33. The moon like white area at the base of the nail.
HCPCS Level II codes (National Codes)
lunula
Group Insurance
Accept assignment
34. Is a group of two or more physicians and non-physician practitioners legally organized in a partnership - professional corporation - foundation - not-for-profit corporation - faculty practice plan - or similar association.
Group practice
There are two types of sweat glands
premium
Alopecia
35. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.
Evaluation and Management Review
Category II Codes CPT
Pre-certification
Surgical Package
36. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Suicide Attempt
Occipital Bone
ligaments
Accept assignment
37. The Usual - Customary - and Reasonable: The UCR method is used mostly in reference to fee-for-service reimbursement. To arrive at a payment amount for a claim - the carrier compares: The physician's most frequent charge for a given service (the usual
Medical necessity
Fee Schedule
Add-on codes
Evaluation and Management Review
38. Created the Health Care Fraud and Abuse Control Program enacted to check for fraud and abuse in the Medicare and Medicaid programs - and private payers.
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Dirty claim
Birthday rule
HCPCS Level II codes (National Codes)
39. Standard - fee-for-service - cost-sharing plan ; Extra - preferred provider organization ;Prime - health maintenance organization plan with a point-of-service option All of the above-mentioned plans covered under TRICARE - with the exception of Prime
Civil Monetary Penalties Law (CMPL)
TRICARE PLANS
Advance Beneficiary Notice
Vesicle
40. 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.
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
A plus sign (+)
Accident
New patient
41. 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.
Category III Codes CPT
Physician
Hairline
Gangrene
42. Is a cost-sharing requirement for the insured to pay at the time of service. This amount is usually a specific dollar amount (e.g.. $15 - $20 - $25)
Primary malignancy
co-payment
sprain
Explanation of Benefits (EOB)
43. Are small - rounded bones that resemble a sesame seed. They are found near joints and increase the efficiency of muscles near a joint. An example of sesamoid bone is the knee cap.
Liability insurance
New Patient
Sesamoid bones
Medicaid
44. Is a policy that covers losses to a third party caused by the insured - by an object owned by the insured - or on premises owned by the insured. Liability insurance claims are made to cover the cost of medical care for traumatic injuries - lost wages
A plus sign (+)
Category III Codes CPT
Relative Value Payment Schedules Method
Liability insurance
45. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients
Accident
Social Security Number
HCPCS Level I codes
Liability insurance
46. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
Peer Review Organization (PRO)
Qualified diagnosis
Lacrimal bones
Full ROM
47. The epidermis - the dermis - and the subcutaneous layer. The epidermis is a thin - cellular membrane layer that contains keratin. The dermis is a dense - fibrous - connective tissue that contains collagen. The subcutaneous layer is a thicker and fatt
There are three layers to the skin
Subcategories
Peer Review Organization (PRO)
Medicare
48. Noninvasive - non-spreading - nonmalignant
Colles
Location Methods
Benign
Gender rule
49. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Employer Identification Number (EIN)
Gangrene
MEDICAID COVERAGE
HCPCS Level II codes (National Codes)
50. This is defined as incidents or practices - not usually considered fraudulent - that are inconsistent with the accepted medical business or fiscal practices in the industry. Examples of abuse are submitting a claim for a service or procedure performe
Hairline
Review of Systems (ROS)
Abuse
Pre-certification