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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
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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. 'Errors and omissions insurance' is protection against loss of monies caused by failure through error or unintentional omission on the part of the individual or service submitting the insurance claim. Some physicians' contract with a billing service
Colles
Employee Liability
phalanges (phalanx.s)
Fraud
2. Is the lateral lower arm bone (in line with the thumb).
Radius
Unique Provider Identification Number (UPIN)
Chief complaint (CC)
Malignant
3. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called
Explanation of Benefits (EOB)
Evaluation and Management Review
Keratin
Liability insurance
4. Is a percentage of the cost of covered services that a policyholder or a secondary insurance pays. A common payment percentage for coinsurance is 80/20 which indicates that 20% is the coinsurance for which the beneficiary or secondary insurance is re
Coinsurance
Abuse
Mandible
No ROM
5. are small with irregular shapes. They are found in the wrist and ankle.
Wheal
Short bones
Sections
Non-covered benefit
6. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
Inferior nasal conchae
Deductible
Fiscal Intermediary
Two triangular symbols (a
7. make up part of the roof of the mouth
-50 - Bilateral Procedure
Collagen
circle with a line through it)
Palatine bones
8. Is an entity that receives transmissions of claims from physicians' offices - separates the claims by carriers and performs software edits on each claim to check for errors. Once this process is complete - the claim is then sent to the proper insuran
Patient Confidentiality
Lacrimal bones
Clearinghouse
Radius
9. This modifier is used when the same procedure is performed on a mirror-image part of the body..
Sebaceous glands
Liability insurance
Chief complaint (CC)
-50 - Bilateral Procedure
10. 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.
Social Security Number
TRICARE PLANS
-50 - Bilateral Procedure
Medicaid
11. represents Exemption from the use of modifier -51
Medigap (Medicare Supplemental Insurance)
circle with a line through it)
History
Patient Confidentiality
12. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
Category I Codes CPT
Remittance Advice
Health Insurance Portability and Accountability Act (HIPAA)
Flat bones
13. All patients have a right to privacy and all information should remain privileged. Discuss patient information only with the patient's physician or office personnel that need certain information to do their job. Obtain a signed consent form to releas
Patient Confidentiality
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Medicare Claim Status
Compression fracture
14. 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
Clean claim
Paper Claim
The Patient Care Partnership (Patient's Bill of Rights)
Mandible
15. Consists of the skull - rib cage - and spine
axial skeleton
Birthday rule
National Correct Coding Initiative (NCCI)
State License Number
16. The main term in the index may by followed by terms within parenthesis.
Alphabetic Index (Volume 2)
Group Provider Number
Invalid claim
The Patient Care Partnership (Patient's Bill of Rights)
17. Benign growth extending from the surface of the mucous membrane
National Correct Coding Initiative (NCCI)
Polyp
Pubic bone
Greenstick
18. Discolored - flat lesion (freckles - tattoo marks)
Preferred Provider Organization (PPO)
Point-of-Service plan (POS)
Assault
Macule
19. The lower anterior part of the bone
History of present illness (HPI)
Pubic bone
Benign (hypertension)
Outpatient
20. 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.
itemized statement
Peer Review Organization (PRO)
Colles
Primary malignancy
21. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Category III Codes CPT
Coding
False ribs
stand-alone codes
22. Number assigned by the insurance company to a physician who renders services to patients.
Provider Identification Number (PIN)
true ribs
eponychium
triangle (a
23. A fat cell
Explanation of Benefits (EOB)
Retention of Medical Records
Lacrimal bones
Lipocyte
24. 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.
Blue Cross/Blue Shield Plans
co-payment
Group practice
Gangrene
25. 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
Point-of-Service plan (POS)
Unspecified nature
Fraud
Physician
26. Small collection of clear fluid;blister
Lacrimal bones
Vesicle
Subcategories
There are three layers to the skin
27. Groove or crack like sore
Primary malignancy
HCPCS Level I codes
Reasons for Documentation
Fissure
28. This is not specified as benign or malignant in the diagnosis or medical record.
Unspecified (hypertension)
Temporal Bone
-32 - Mandated Services
phalanges (phalanx.s)
29. 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
HCPCS Level I codes
Dirty claim
stand-alone codes
circle with a line through it)
30. major skin pigment
Unspecified nature
Disability insurance
Melanin
TRICARE PLANS
31. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
axial skeleton
Musculoskeletal System
encounter form
Deductible
32. 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.
premium
Sesamoid bones
Health practitioner
Melanin
33. 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
CPT SECTIONS.
Group practice
Commercial Carriers
TRICARE PLANS
34. Are the main division in the ICD-9-CM; they are divided into sections. e.g.. - 3. Endocrine - Nutritional and Metabolic Diseases - and Immunity Disorders (240-279).
Flat bones
Parietal Bones
Chapters
Undetermined
35. Are codes formulated thru the joint efforts of the CMS - the Health Insurance Association of America - and the Blue Cross and Blue Shield Association. Level II contains five position alpha-numeric codes for physician and non-physician services not fo
Health Care Financing Administration Common Procedure Coding System
Humerus
Coinsurance
HCPCS Level II codes (National Codes)
36. 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
Medical necessity
-99 - Multiple Modifiers
Medigap (Medicare Supplemental Insurance)
Compliance Regulations
37. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
National Correct Coding Initiative (NCCI)
Exclusions and Limitations
Unspecified nature
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
38. requires investigation and needs further clarification.
Rejected claim
Melanin
Accident
Sections
39. Is one who has no contract with the health insurance plan.
Zygoma
Vesicle
Secondary malignancy
Nonparticipating physician
40. 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'.
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Modifiers
Fraud
Pre-authorization
41. Is the upper arm bone.
Humerus
Past - family and social history (PFSH)
Personal Insurance
Palatine bones
42. 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.
Group practice
Disability insurance
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Modifiers
43. A fat cell
Medical Records
Carcinoma (Ca) in situ
New patient
Lipocyte
44. These parenthetic terms are called because their presence or absence does not have an effect on the selection of the code listed for the main term.
Chapters
Group Provider Number
nonessential modifiers
Established patient
45. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
Long bones
Dirty claim
Medicaid
Workers Compensation
46. 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
phalanges (phalanx.s)
Employer Liability
Colles
47. - 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
Medigap (Medicare Supplemental Insurance)
Deductible
Vesicle
Pre-authorization
48. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
Wheal
History of present illness (HPI)
Patient Confidentiality
-32 - Mandated Services
49. Further classified as to primary - secondary - or carcinoma in situ.
Sesamoid bones
Qualified diagnosis
Malignant
true ribs
50. 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:
Patient Confidentiality
CPT SECTIONS.
Hypertension Table
Rejected claim