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Test your basic knowledge |
Medical Billing And Coding Vocab
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Subject
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medical-transcription
Instructions:
Answer 50 questions in 15 minutes.
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study here
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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. The cuticle at the lower part of the nail and this is sometimes referred to as the
A plus sign (+)
eponychium
Melanin
Pre-authorization
2. 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
History of present illness (HPI)
Qualified diagnosis
Medicare
Consultation
3. The CPT manual is composed of eight sections. Each section begins with guidelines that provide specific coding rules for that section. Guidelines at the beginning of the section are applicable to all codes in the section - while notes that pertain t
Invalid claim
CPT SECTIONS.
Workers Compensation
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
4. forms the two lower sides of the cranium.
Gangrene
Temporal Bone
Personal Insurance
Dirty claim
5. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Employer Identification Number (EIN)
Performing Provider Identification Number (PPIN)
Sub classification
Pre-paid Health Plan
6. The bone is broken and pierces an internal organ
Sections
Complicated
Fee Schedule
essential modifiers
7. Federal law that prohibits submitting a fraudulent claim or making a false statement or representation in connection with a claim. It also protects and rewards persons involved in whistle-blower cases.
axial skeleton
False Claims Act (FCA)
Zygoma
Malignant
8. 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
Category III Codes CPT
MEDICARE Part D
The St. Anthony Relative Value for Physicians (RVP)
False ribs
9. Discolored - flat lesion (freckles - tattoo marks)
Abuse
Alphabetic Index (Volume 2)
Surgical Package
Macule
10. Is a patient who receives treatment in any of the following settings: physician's office ;hospital clinic - emergency department - hospital same-day surgery unit - ambulatory surgical center ( patient is released within 23 hours) ;hospital admission
The Integumentary System
Zygoma
Outpatient
Clean claim
11. Medicaid is the payer of last resort. If the patient has Medicare and Medicaid - Medicaid usually pays for the Medicare Part B deductible - coinsurance - and monthly premium amounts. Some of the services covered by Medicaid include the following: Inp
Disability insurance
Medicare Claim Status
Deductible
MEDICAID COVERAGE
12. 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
The Current Procedural Terminology (CPT)
Civil Monetary Penalties Law (CMPL)
Inferior nasal conchae
Greenstick
13. Considered experimental - newly approved - or seldom used may not be listed in the CPT manual. These codes can be coded as unlisted procedures. They are located at the end of the subsections or subheadings. When an unlisted procedure code is reported
CPT SECTIONS.
Unlisted Procedures Procedures
itemized statement
Coordination of Benefits (COB)
14. 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.
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Non-covered benefit
Albino
Retention of Medical Records
15. most synarthroses are immovable joints held together by fibrous tissue.
co-payment
No ROM
Coinsurance
The Integumentary System
16. anterior to the temporal bones.
Mutually Exclusive Edits
Sphenoid Bones
Health Maintenance Organization (HMO)
Radius
17. 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
Capitated Rates
Remittance Advice
Melanin
There are three layers to the skin
18. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body
Secondary malignancy
sebaceous(oil) glands and the suddoriferous (sweat) glands
premium
essential modifiers
19. 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:
Pathologic
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Sphenoid Bones
Hypertension Table
20. The lower anterior part of the bone
Pubic bone
Advance Beneficiary Notice
eponychium
Compliance Regulations
21. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Employer Identification Number (EIN)
History of present illness (HPI)
Unspecified nature
Health practitioner
22. A fracture of the epiphyseal plate in children.
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
itemized statement
Chief complaint
Salter-Harris
23. The break of the distal end of the radius at the epiphysis often occurs when the patient has attempted to break his or her fall.
Colles
Assault
Coding
MEDICARE Part C
24. Developed by the CMS to promote national correct coding methodologies and to control improper coding that leads to inappropriate payment of Part B health insurance claims.
Established patient
Fissure
Non-covered benefit
National Correct Coding Initiative (NCCI)
25. includes the shoulder girdle which is made up of the scapula - clavicle and upper extremities. The scapula - or shoulder blades are flat bones that help support the arms. The clavicle - or collarbone - is curved horizontal bones that attach to the u
MEDICARE Part B
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Colles
upper appendicular skeleton
26. uncertain whether benign or malignant; borderline malignancy
Melanin
Uncertain behavior
The Universal Claim Form
Disability insurance
27. is a traumatic injury to a joint involving the soft tissue.
sprain
Multigravida
Employer Liability
Pathologic
28. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
-32 - Mandated Services
Wheal
Maxilla
Multigravida
29. This modifier is used when the same procedure is performed on a mirror-image part of the body..
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Neoplasm Table
Comminuted fracture
-50 - Bilateral Procedure
30. Is one who has no contract with the health insurance plan.
Employer Identification Number (EIN)
Zygoma
Categories
Nonparticipating physician
31. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
Malignant
phalanges (phalanx.s)
sprain
Surgical Package
32. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Medical necessity
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Mutually Exclusive Edits
Pathologic
33. Is the cost of insurance coverage paid annually - semi-annually or monthly to keep a policy in effect.
Clean claim
Preferred Provider Organization (PPO)
Assault
premium
34. 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
ligaments
Employee Liability
Spinal/Vertebral Column
Benign
35. 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.
Sesamoid bones
Hypertension Table
Civil Monetary Penalties Law (CMPL)
Gangrene
36. This modifier is used when the same procedure is performed on a mirror-image part of the body..
Category II Codes CPT
Liability insurance
Physician
-50 - Bilateral Procedure
37. provides a five-digit code which gives the highest specificity of description to a condition. Use of it is mandatory if it is available. A code not reported to the full number of digits required is invalid. e.g. 240.01 Toxic diffuse goiter with thyr
Multigravida
Electronic Claim
Sub classification
Alphabetic Index (Volume 2)
38. Is a service performed by a physician whose opinion or advice is requested by another physician in the evaluation or treatment of a patient's illness or suspected problem. The consultant does not assume responsibility for the patient's care and must
Add-on codes
Category III Codes CPT
eponychium
Consultation
39. 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.
Commercial Carriers
Fiscal Intermediary
Hairline
itemized statement
40. Is a fee that is charged for each procedure or service performed by the physician. This fee is obtained from a fee schedule - which is a list of charges or allowance that have accepted for specific medical services. The system in which fee schedules
Social Security Number
Fee-for-Service
HCPCS Level I codes
Physician
41. When a group of employees and their dependents are insured under one (1) group policy issued to the employer. Generally - the employer pays the premium or a portion of the premium and the employee pays the difference. This all depends on the type of
Group Insurance
Compliance Regulations
Medical necessity
Suicide Attempt
42. Poisoning was due to: Accidental overdose; Wrong substance taken; Accidents in use of drugs and biologicals; External causes of poisonings classifiable to 980-989 Therapeutic Use: instances when a correct substance properly taken is the cause of adve
Multigravida
National Correct Coding Initiative (NCCI)
Accident
Pre-paid Health Plan
43. To report a circumstance in which the physician returns to the operating room to address a complication stemming from the initial procedure - modifier -78 is attached to the subsequent procedure code.
Sesamoid bones
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Vomer
44. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Exclusions and Limitations
Coding
Qualified diagnosis
Alopecia
45. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
Medically needy
Medigap (Medicare Supplemental Insurance)
-26 - Professional Component
ligaments
46. This is a set of information the physician gathers from the patient regarding the following:
Tabular List (Volume 1)...
History
Preferred Provider Organization (PPO)
False ribs
47. This consists of the patient's personal experiences with illnesses - surgeries and injuries. It also contains information of illnesses predominant in the family. It contains the patient's educational background - occupation - marital status - and oth
Group Provider Number
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
The Universal Claim Form
Past - family and social history (PFSH)
48. Number assigned to the physician by Medicare program.
appendicular skeleton .
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
The Good Samaritan Act
Unique Provider Identification Number (UPIN)
49. A chronological account of the development of the complaint from the first sign or symptom that the patient experienced to the present
triangle (a
Health Care Financing Administration Common Procedure Coding System
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
History of present illness (HPI)
50. Is the upper arm bone.
Qualified diagnosis
Humerus
Ischium
Musculoskeletal System