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Test your basic knowledge |
Medical Billing And Coding Vocab
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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. Is the lateral lower arm bone (in line with the thumb).
Chapters
Radius
Neoplasm Table
Qualified diagnosis
2. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
Pre-authorization
Undetermined
Coinsurance
Wheal
3. 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'.
Pre-authorization
Gangrene
premium
Disability insurance
4. Law passed by the federal government to prosecute cases of Medicaid fraud.
Group Provider Number
Civil Monetary Penalties Law (CMPL)
Retention of Medical Records
History
5. numbers 8-10 - are attached to the sternum by cartilage
False ribs
Qualified diagnosis
Medicare
Relative Value Payment Schedules Method
6. The lower anterior part of the bone
New Patient
Surgical Package
Pubic bone
Category III Codes CPT
7. This is the traditional method used by providers for submission of charges to insurance companies. The most commonly used form is the CMS-1500. Few plans still accept the physician's encounter form or superbill and Medicare will only accept claims on
Liability insurance
Zygoma
Paper Claim
Accident
8. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Performing Provider Identification Number (PPIN)
-51 - Multiple Procedures
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Chief complaint
9. Produce secretions that allow the body to be moisturized or cooled.
Zygoma
Modifiers
Hypertension Table
sebaceous(oil) glands and the suddoriferous (sweat) glands
10. The main term in the index may by followed by terms within parenthesis.
Carpals
Alphabetic Index (Volume 2)
MEDICARE Part A
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
11. Forms the sides of the cranium
Vomer
Impetigo
Sections
Parietal Bones
12. This is the traditional method used by providers for submission of charges to insurance companies. The most commonly used form is the CMS-1500. Few plans still accept the physician's encounter form or superbill and Medicare will only accept claims on
Medicare
Paper Claim
Contracted Rates with MCOs
Impetigo
13. Retention of medical records is governed by state and local laws and may vary from state-to-state. Most physicians are required to retain records indefinitely; deceased patient records should be kept for at least five (5) years.
Retention of Medical Records
Coding
Alphabetic Index (Volume 2)
Surgical Package
14. Under capitation - the physician provides a full range of contracted services to covered patients for a fixed amount on a periodic basis. While guaranteed a fixed amount - the physician assumes the risk that the cost of providing the care to the pati
Civil Monetary Penalties Law (CMPL)
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Capitated Rates
Paper Claim
15. anterior to the temporal bones.
Hypertension Table
Review of Systems (ROS)
Musculoskeletal System
Sphenoid Bones
16. forms the roof of the nasal cavity.
The Good Samaritan Act
Ethmoid Bone
Workers Compensation
Parietal Bones
17. major skin pigment
Melanin
Coding
Electronic Claim
Health Care Financing Administration Common Procedure Coding System
18. Codes from the CPT codebook are used to report services and procedures by physicians. It is published and updated annually by the American Medical Association (AMA) with a new one coming out each November and becoming effective on January 1st of the
There are two types of sweat glands
The Current Procedural Terminology (CPT)
Established Patient
Melanin
19. Numbers 1-7 - attach directly to the sternum in the front of the body.
true ribs
Benign (hypertension)
Group Provider Number
Categorically needy -MEDICAID
20. There are also terms indented two spaces to the right below the main term called subterms. These subterms are because they have bearing in the selection of the right code. Everything in the Index is listed by condition - that is - diagnosis - signs -
essential modifiers
Subcategories
true ribs
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
21. Cheekbone
Tabular List (Volume 1)...
Zygoma
Eligibility
The Good Samaritan Act
22. Knowingly and intentionally deceiving or misrepresenting information that may result in unauthorized benefits is known as fraud.. Common forms of fraud are billing for services not furnished - unbundling - and misrepresenting diagnosis to justify pay
Fraud
Consultation
Keratin
Contracted Rates with MCOs
23. 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
Exclusions and Limitations
ligaments
lunula
Employer Liability
24. Noninvasive - non-spreading - nonmalignant
The Universal Claim Form
Group Provider Number
Categories
Benign
25. .. lower jaw bone.
Personal Insurance
National Correct Coding Initiative (NCCI)
Mandible
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
26. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
Inferior nasal conchae
Deductible
Group Provider Number
co-payment
27. Discolored - flat lesion (freckles - tattoo marks)
Macule
Category II Codes CPT
-50 - Bilateral Procedure
Sebaceous glands
28. Physicians agree to provide services at a discount of their usual fee in return for a pool of existing patients.
Collagen
The Integumentary System
Contracted Rates with MCOs
Gangrene
29. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
Section 3 Index to External Causes of Injury (E codes)
Medigap (Medicare Supplemental Insurance)
Multigravida
Rib Cage
30. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
National Correct Coding Initiative (NCCI)
Flat bones
ligaments
Unauthorized benefit
31. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.
A plus sign (+)
False ribs
Advance Beneficiary Notice
Participating physician
32. This modifier is used when the same procedure is performed on a mirror-image part of the body..
Contracted Rates with MCOs
Employer Liability
Add-on codes
-50 - Bilateral Procedure
33. the bone is crushed and or shattered.
Sections
Preferred Provider Organization (PPO)
The St. Anthony Relative Value for Physicians (RVP)
Comminuted fracture
34. Are supplementary classification codes used to identify health care encounters that occur for reasons other than illness or injury or to identify patients whose illness is influenced by special circumstances or problems. The codes can be found in bot
National Correct Coding Initiative (NCCI)
Multigravida
Provider Identification Number (PIN)
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
35. This modifier is used when the same procedure is performed on a mirror-image part of the body..
-50 - Bilateral Procedure
sebaceous(oil) glands and the suddoriferous (sweat) glands
itemized statement
Limited ROM
36. 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
MEDICARE Part D
eponychium
Hairline
Coinsurance
37. Indicates add-on codes
appendicular skeleton .
A plus sign (+)
Inferior nasal conchae
Eligibility
38. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
Rib Cage
Medicare Claim Status
Secondary malignancy
Unlisted Procedures Procedures
39. Pre-determined set of benefits covered under one set annual fee.
Uncertain behavior
Pre-paid Health Plan
Malignant
Chapters
40. forms the back of the skull. There is a large hole at the ventral surface in this bone - called the foramen magnum - which allows the brain communication with the spinal cord
MEDICAID COVERAGE
Retention of Medical Records
Occipital Bone
No ROM
41. 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.
Polyp
Sesamoid bones
Rib Cage
Peer Review Organization (PRO)
42. paired bones at the corner of each eye that cradle the tear ducts.
Zygoma
Lacrimal bones
Location Methods
Location Methods
43. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
The Good Samaritan Act
Tabular List (Volume 1)...
Blue Cross/Blue Shield Plans
Categories
44. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Coding
Hairline
stand-alone codes
Physician
45. Medicare Managed Care Plans (Formerly Medicare Plus (+) Choice Plan) was created to offer a number of healthcare services in addition to those available under Part A and Part B. The CMS contracts with managed care plans or provider service organizati
MEDICARE Part D
Exclusions and Limitations
MEDICARE Part C
Abuse
46. Has all required fields accurately filled out - contains no deficiencies and passes all edits. The carrier does not require investigation outside of the carrier's operation before paying the claim.
Established Patient
Clean claim
Chief complaint
There are two types of sweat glands
47. 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.
Explanation of Benefits (EOB)
Benign
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Sesamoid bones
48. 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
The Integumentary System
Medicare Claim Status
Group Insurance
MEDICARE Part B
49. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
Ethmoid Bone
Medically needy
Ulcermembranes
Sebaceous glands
50. Was created to provide medical benefits to spouses and children of veterans with total - permanent service related disabilities or for surviving spouses and children of a veteran who died as a result of service-related disability. It is a service ben
Qualified diagnosis
Sections
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Complicated