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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. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Vesicle
Uncertain behavior
2. contains errors or omissions. Usually - these claims do not pass front-end edits. They are either processed manually for resolving problems - or rejected for payment.
Non-covered benefit
Assault
nonessential modifiers
Dirty claim
3. This is a set of information the physician gathers from the patient regarding the following:
History
Wheal
Pathologic
Modifiers
4. forms the two lower sides of the cranium.
Temporal Bone
encounter form
National Correct Coding Initiative (NCCI)
Chief complaint
5. This is attached to the code of the E/M service provided to a patient during the postoperative period to indicate that that service is not part of the postoperative care which is usually part of a package of services of the surgery performed. Major s
Nodule
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
MEDICARE Part A
Lipocyte
6. 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..
Civil Monetary Penalties Law (CMPL)
Sebaceous glands
Musculoskeletal System
Flat bones
7. Is one who has received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years....
Established patient
Complicated
Tabular List (Volume 1)...
Dirty claim
8. represents Exemption from the use of modifier -51
sprain
Colles
circle with a line through it)
HCPCS Level I codes
9. Benign growth extending from the surface of the mucous membrane
Polyp
Clean claim
Employer Identification Number (EIN)
Fraud
10. The CPT Index is arranged in alphabetical order by main terms which are further divided by subterms. There are five location methods: 1. Service or Procedure 2. Anatomic site 3. Condition or Disease 4. Synonym/Eponym 5. Abbreviation
National Correct Coding Initiative (NCCI)
Secondary malignancy
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Location Methods
11. 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.
Coding
Categories
Humerus
National Correct Coding Initiative (NCCI)
12. In July 2001 - the Health Care Financing Administration (HCFA) became the Centers for Medicare & Medicaid Services (CMS) - and the universal claim form HCFA-1500 became the CMS-1500.Virtually all third-party payers will accept it - and Medicare requ
The Universal Claim Form
Pelvis
No ROM
Medical Records
13. Produce secretions that allow the body to be moisturized or cooled.
Inferior nasal conchae
The St. Anthony Relative Value for Physicians (RVP)
sebaceous(oil) glands and the suddoriferous (sweat) glands
Past - family and social history (PFSH)
14. 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
Relative Value Payment Schedules Method
Liability insurance
New Patient
Employee Liability
15. 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.
Capitated Rates
Nodule
Retention of Medical Records
Fee Schedule
16. Is the lower medial arm bone.
Impetigo
Past - family and social history (PFSH)
ulna
New patient
17. Discolored - flat lesion (freckles - tattoo marks)
MEDICARE Part C
Malignant
Macule
phalanges (phalanx.s)
18. most synarthroses are immovable joints held together by fibrous tissue.
Eligibility
No ROM
New Patient
MEDICARE Part D
19. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Accept assignment
Greenstick
The Patient Care Partnership (Patient's Bill of Rights)
Unlisted Procedures Procedures
20. It is important that every patient seen by the physician has comprehensive legible documentation about the patient's illness - treatment and plans for the following reasons Avoidance of denied or delayed payments by insurance carriers investigating t
Reasons for Documentation
Pre-paid Health Plan
Group Provider Number
Gangrene
21. is defined as one who has not received any medical services within the last three years.
itemized statement
New Patient
Group Provider Number
Albino
22. the bone is crushed and or shattered.
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Comminuted fracture
Keratin
Categories
23. Law passed by the federal government to prosecute cases of Medicaid fraud.
There are two types of sweat glands
Birthday rule
Civil Monetary Penalties Law (CMPL)
Section 3 Index to External Causes of Injury (E codes)
24. - 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)
Workers Compensation
Musculoskeletal System
Disability insurance
25. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
Ethmoid Bone
Flat bones
Fraud
The Patient Care Partnership (Patient's Bill of Rights)
26. The bones are connected to one another by fibrous bands of tissue . Muscles are attached to the bone by tendons. The fibrous covering of the muscles is called the fascia
MEDICARE Part B
true ribs
appendicular skeleton .
ligaments
27. 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
Pre-determination
Fee Schedule
Add-on codes
The Integumentary System
28.
Alopecia
Gender rule
Mandible
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
29. Are supplemental codes used for performance measurements. Although these codes are intended to facilitate data collection about the quality of care - their use is optional. Category II codes are published twice a year: January 1st and July 1st.
Melanin
nonessential modifiers
-32 - Mandated Services
Category II Codes CPT
30. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
The Current Procedural Terminology (CPT)
Primary malignancy
Chapters
Coinsurance
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.
Deductible
upper appendicular skeleton
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Hypertension Table
32. A medical record is documentation on the patient's social and medical history - family history - physical examination findings - progress notes - radiology and lab results - consultation reports and correspondence to patient.
Medical necessity
Medical Records
TRICARE
HCPCS Level I codes
33. A pregnant woman who has had at least one previous pregnancy.
Disability insurance
Multigravida
Sub classification
History of present illness (HPI)
34. Is the qualifying factor or factors that must be met before a patient receives benefits.
Parietal Bones
Eligibility
Explanation of Benefits (EOB)
Inferior nasal conchae
35. Is an electronic or paper-based report of payment sent by the payer to the provider.
Remittance Advice
ligaments
State License Number
Benign (hypertension)
36. 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
Subcategories
Categorically needy -MEDICAID
-32 - Mandated Services
Short bones
37. It is important that every patient seen by the physician has comprehensive legible documentation about the patient's illness - treatment and plans for the following reasons Avoidance of denied or delayed payments by insurance carriers investigating t
Health Care Financing Administration Common Procedure Coding System
Polyp
Reasons for Documentation
Categorically needy -MEDICAID
38. uncertain whether benign or malignant; borderline malignancy
Uncertain behavior
Assault
MEDICARE Part D
Spinal/Vertebral Column
39. The plan of the parent whose birthday falls earlier in the year (month and day - not year) is primary to that whose birthday falls later in the year. If both parents have the same birthday - then the plan of the parent who has had the longest coverag
Frontal Bone
Health practitioner
Birthday rule
Ulcermembranes
40. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
New Patient
Remittance Advice
Medical necessity
Medically needy
41. This is attached to the code of the E/M service provided to a patient during the postoperative period to indicate that that service is not part of the postoperative care which is usually part of a package of services of the surgery performed. Major s
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Paper Claim
Medicare Claim Status
New patient
42. 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
Add-on codes
Paper Claim
Established Patient
Medical Records
43. forms the roof of the nasal cavity.
Ethmoid Bone
Comminuted fracture
Surgical Package
Gangrene
44. Physicians agree to provide services at a discount of their usual fee in return for a pool of existing patients.
Nodule
Medically needy
Outpatient
Contracted Rates with MCOs
45. Numbers 1-7 - attach directly to the sternum in the front of the body.
Salter-Harris
HCPCS Level II codes (National Codes)
true ribs
Nonparticipating physician
46. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Chief complaint
Reasons for Documentation
Patient Confidentiality
Carpals
47. forms the two lower sides of the cranium.
Employee Liability
Temporal Bone
TRICARE
Peer Review Organization (PRO)
48. 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
Exclusions and Limitations
Macule
Categories
Accident
49. Are wrist bones. There are 2 rows of four bones in the wrist. The metacarpals are the five radiating bones in the fingers. These are the bones in the palm of the hand.
Lacrimal bones
Subcategories
Carpals
Unlisted Procedures Procedures
50. The fractured area of bone collapses on itself.
Past - family and social history (PFSH)
Compression fracture
Workers Compensation
Medigap (Medicare Supplemental Insurance)