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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. 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
Category II Codes CPT
Inpatient
Liability insurance
The St. Anthony Relative Value for Physicians (RVP)
2. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Chief complaint
Invalid claim
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Medicare
3. consists of 17 chapters based on either body system or cause or type of disease. The codes range from 001-999.
Tabular List (Volume 1)...
Pubic bone
Polyp
Paper Claim
4. 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:
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
-26 - Professional Component
Albino
Hypertension Table
5. Is when two insurance companies work together to coordinate payment of the benefits.
-50 - Bilateral Procedure
Past - family and social history (PFSH)
TRICARE PLANS
Coordination of Benefits (COB)
6. 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
premium
Group Insurance
Radius
Undetermined
7. Superior and widest bone
Group Insurance
Inpatient
Pelvis
Provider Identification Number (PIN)
8. 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
Two triangular symbols (a
Consultation
appendicular skeleton .
bullet (a
9. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
-99 - Multiple Modifiers
Non-covered benefit
Provider Identification Number (PIN)
Chief complaint
10. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
Past - family and social history (PFSH)
Sections
Hypertension Table
Full ROM
11. 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
Evaluation and Management Review
History of present illness (HPI)
Gangrene
Categories
12. 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)
HCPCS Level I codes
Sesamoid bones
Clean claim
13. make up part of the roof of the mouth
Evaluation and Management Review
Alopecia
Inferior nasal conchae
Palatine bones
14. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
Mutually Exclusive Edits
The Integumentary System
triangle (a
Medically needy
15. 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
Consultation
Paper Claim
State License Number
Review of Systems (ROS)
16. This is a set of information the physician gathers from the patient regarding the following:
Commercial Carriers
History
Flat bones
New Patient
17. HCPCS Reference Manual The CMS assigns a standard unique identifier known as the National Provider Identifier (NPI) The CMS also developed a two-part coding system called the Healthcare Common Procedure Coding System ( HCPCS ) which is a collection o
Assault
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Malignant
Health Care Financing Administration Common Procedure Coding System
18. 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.
-99 - Multiple Modifiers
Preferred Provider plan
Colles
Compression fracture
19. This is not specified as benign or malignant in the diagnosis or medical record.
Unspecified (hypertension)
Provider Identification Number (PIN)
Indemnity Insurance
Contracted Rates with MCOs
20. The bone is broken and pierces an internal organ
Complicated
Explanation of Benefits (EOB)
Birthday rule
Medically needy
21. Represent services and procedures widely used by many health care professionals in clinical practice in multiple locations and have been approved by the FDA.
sebaceous(oil) glands and the suddoriferous (sweat) glands
Peer Review Organization (PRO)
Fee Schedule
Category I Codes CPT
22. This is the inventory of the constitutional symptoms regarding the various body systems.
Review of Systems (ROS)
Full ROM
Impetigo
upper appendicular skeleton
23. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Mutually Exclusive Edits
False ribs
Chief complaint
Malignant
24. 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
Clearinghouse
Paper Claim
Full ROM
Established Patient
25. Is the qualifying factor or factors that must be met before a patient receives benefits.
Eligibility
Advance Beneficiary Notice
Coinsurance
History of present illness (HPI)
26. Provide a four-digit code (one digit after the decimal point) which is more specific than category code (3-digit) in terms of cause - site - or manifestation of the condition. This must be used if available. From subcategory - specificity moves to an
Ethmoid Bone
Malignant
-50 - Bilateral Procedure
Subcategories
27. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Unspecified nature
Outpatient
Group Provider Number
Impacted
28. Benign growth extending from the surface of the mucous membrane
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Add-on codes
Polyp
-32 - Mandated Services
29. Small collection of clear fluid;blister
History of present illness (HPI)
Musculoskeletal System
Vesicle
Comminuted fracture
30. 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
Medically needy
HCPCS Level II codes (National Codes)
Electronic Claim
Coordination of Benefits (COB)
31. Is a document provided to a Medicare beneficiary by a provider prior to service being rendered letting the beneficiary know of his/her responsibility to pay if Medicare denies the claim.
Advance Beneficiary Notice
Medically needy
Sebaceous glands
Comminuted fracture
32. 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
Chief complaint
MEDICAID COVERAGE
phalanges (phalanx.s)
33. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the
Patient Confidentiality
MEDICARE Part A
Remittance Advice
Social Security Number
34. 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
Performing Provider Identification Number (PPIN)
Carpals
Location Methods
Abuse
35. The musculoskeletal system includes the bones - muscles - and joints The musculoskeletal system acts as a framework for the organs - protects many of those organs - and also provides the organism the ability to move..
Employee Liability
Two triangular symbols (a
The Current Procedural Terminology (CPT)
Musculoskeletal System
36. Groove or crack like sore
Complicated
Fissure
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Dirty claim
37. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called
Coinsurance
Keratin
Medically needy
Patient Confidentiality
38. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
MEDICARE Part B
Unspecified nature
Ulcermembranes
Preferred Provider plan
39. Physicians agree to provide services at a discount of their usual fee in return for a pool of existing patients.
Contracted Rates with MCOs
HCPCS Level II codes (National Codes)
Fraud
Unauthorized benefit
40. most synarthroses are immovable joints held together by fibrous tissue.
New patient
No ROM
Frontal Bone
Pre-authorization
41. 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
-90 - Reference (Outside) Laboratory
Fee-for-Service
Lacrimal bones
Tabular List (Volume 1)...
42. uncertain whether benign or malignant; borderline malignancy
CPT SECTIONS.
Uncertain behavior
Wheal
Temporal Bone
43. Produce secretions that allow the body to be moisturized or cooled.
sebaceous(oil) glands and the suddoriferous (sweat) glands
-51 - Multiple Procedures
Salter-Harris
Impacted
44. is defined as reimbursement for income lost as a result of a temporary or permanent illness or injury. When patients are treated for disability diagnoses and other medical problems - separate patient records must be maintained. Disability insurance
Greenstick
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Disability insurance
Ischium
45. the bone is broken and the ends are driven into each other.
Medicare Claim Status
Participating physician
Impacted
Hairline
46. Contains complete - necessary information - but is incorrect or illogical in some way.
Invalid claim
MEDICARE Part A
ulna
Medically needy
47. is defined as reimbursement for income lost as a result of a temporary or permanent illness or injury. When patients are treated for disability diagnoses and other medical problems - separate patient records must be maintained. Disability insurance
Invalid claim
Group practice
Disability insurance
Parietal Bones
48. open sore on the skin or mucous
Unauthorized benefit
Gender rule
true ribs
Ulcermembranes
49. Numbers 1-7 - attach directly to the sternum in the front of the body.
true ribs
MEDICARE Part A
Sub classification
Undetermined
50. 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)
No ROM
Ulcermembranes
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
co-payment