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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. '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
Clean claim
MEDICARE Part D
Employee Liability
Patient Confidentiality
2. Indicates add-on codes
Pre-certification
Radius
A plus sign (+)
Past - family and social history (PFSH)
3. 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
Compression fracture
Occipital Bone
Group Insurance
Parietal Bones
4. This is located in the Index under the main term 'Neoplasm' and is organized by anatomic site. Each site has six columns with six possible codes determined by whether the neoplasm is malignant - benign - of uncertain behavior - or of unspecified natu
There are three layers to the skin
Neoplasm Table
Remittance Advice
Medigap (Medicare Supplemental Insurance)
5. This modifier is used when the same procedure is performed on a mirror-image part of the body..
Provider Identification Number (PIN)
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
sebaceous(oil) glands and the suddoriferous (sweat) glands
-50 - Bilateral Procedure
6. 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 Records
sprain
appendicular skeleton .
The Integumentary System
7. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
Malignant
Fee Schedule
Medical Records
Limited ROM
8. is defined as one who has not received any medical services within the last three years.
Subcategories
sebaceous(oil) glands and the suddoriferous (sweat) glands
False ribs
New Patient
9. 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
The Good Samaritan Act
There are two types of sweat glands
Occipital Bone
Surgical Package
10. Number assigned by the insurance company to a physician who renders services to patients.
Provider Identification Number (PIN)
Peer Review Organization (PRO)
eponychium
Complicated
11. Is the lower medial arm bone.
MEDICARE Part D
ulna
Peer Review Organization (PRO)
Point-of-Service plan (POS)
12. Is defined as a doctor of medicine or osteopathy - dental medicine - dental surgery - podiatric medicine - optometry - or chiropractic medicine legally authorized to practice by the state in which he/she performs.
appendicular skeleton .
Malignant
Physician
Limited ROM
13. Is when two insurance companies work together to coordinate payment of the benefits.
Coordination of Benefits (COB)
Employer Identification Number (EIN)
phalanges (phalanx.s)
Exclusions and Limitations
14. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Disability insurance
Subcategories
Group Insurance
Accept assignment
15. Represents a new procedure or service code added since the previous edition of the manual.
Hairline
Lipocyte
bullet (a
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
16. Is a term used when a patient is admitted to the hospital with the expectation that the patient will stay for a period of 24 hours or more.
phalanges (phalanx.s)
Participating physician
Inpatient
TRICARE
17. This involves the use of relative value scales which assign a relative weight to individual services according to the basis for the scale. Services that are more difficult - time consuming - or resource intensive to perform typically have higher rela
Ulcermembranes
Relative Value Payment Schedules Method
Macule
Outpatient
18. The cuticle at the lower part of the nail and this is sometimes referred to as the
Peer Review Organization (PRO)
eponychium
-50 - Bilateral Procedure
Musculoskeletal System
19. Is an electronic or paper-based report of payment sent by the payer to the provider.
Remittance Advice
Medical necessity
Melanin
Preferred Provider Organization (PPO)
20. The lower anterior part of the bone
-90 - Reference (Outside) Laboratory
Pubic bone
stand-alone codes
Subcategories
21. Standard - fee-for-service - cost-sharing plan ; Extra - preferred provider organization ;Prime - health maintenance organization plan with a point-of-service option All of the above-mentioned plans covered under TRICARE - with the exception of Prime
Electronic Claim
Fraud
TRICARE PLANS
Temporal Bone
22. The moon like white area at the base of the nail.
Group Insurance
Unlisted Procedures Procedures
Radius
lunula
23. Bone that forms posterior/inferior part of the nasal septal wall between the nostrils.
Vomer
Radius
Pre-paid Health Plan
Accept assignment
24. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.
Pre-certification
Category III Codes CPT
Medicaid
Fee-for-Service
25. 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
Preferred Provider Organization (PPO)
There are three layers to the skin
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Section 3 Index to External Causes of Injury (E codes)
26. Used for procedures that is always performed during the same operative session as another surgery in addition to the primary service/procedure and is never performed separately.
Add-on codes
-51 - Multiple Procedures
Categories
Greenstick
27. 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
Deductible
Greenstick
Long bones
28. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients
ulna
Ischium
Health Insurance Portability and Accountability Act (HIPAA)
HCPCS Level I codes
29. The reason the patient came to see the physician.
Medically needy
Chief complaint (CC)
History of present illness (HPI)
Qualified diagnosis
30. 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
Complicated
The Patient Care Partnership (Patient's Bill of Rights)
Medigap (Medicare Supplemental Insurance)
31. Are located in the dermal layer of the skin over the entire body - except for the palms of the hands and soles of the feet. The sebaceous glands secrete an oily substance called sebum. Sebum contains lipids that help lubricate the skin and minimize w
Sebaceous glands
Category I Codes CPT
Blue Cross/Blue Shield Plans
itemized statement
32. 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
upper appendicular skeleton
Dirty claim
Greenstick
Impetigo
33. Benign growth extending from the surface of the mucous membrane
Polyp
Civil Monetary Penalties Law (CMPL)
-51 - Multiple Procedures
Health Care Financing Administration Common Procedure Coding System
34. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
Health Insurance Portability and Accountability Act (HIPAA)
-50 - Bilateral Procedure
Categorically needy -MEDICAID
Established patient
35. The poisoning was self-inflicted.
Suicide Attempt
bullet (a
The Current Procedural Terminology (CPT)
Gangrene
36. Represents a new procedure or service code added since the previous edition of the manual.
False ribs
Established patient
bullet (a
The Universal Claim Form
37. Small collection of clear fluid;blister
Vesicle
-32 - Mandated Services
MEDICARE Part B
Unspecified nature
38. 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 Records
Lacrimal bones
Ulcermembranes
Two triangular symbols (a
39. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
Fraud
Primary malignancy
MEDICARE Part C
Full ROM
40. Is a state-required insurance plan - the coverage of which provides benefits to employees and their dependents for work related injury - illness or death. Each state has an established minimum number of employees required before this law comes into e
Medicare Claim Status
-90 - Reference (Outside) Laboratory
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Workers Compensation
41. This modifier is used to indicate that the procedure was done by an outside laboratory and not by the reporting facility or clinic.
Malignant
-90 - Reference (Outside) Laboratory
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Colles
42. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
Carcinoma (Ca) in situ
State License Number
The Integumentary System
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
43. Is a working diagnosis which is not yet established.
The Patient Care Partnership (Patient's Bill of Rights)
Qualified diagnosis
appendicular skeleton .
Subcategories
44. Was developed to promote the interests and well being of the patients and residents of the healthcare facility. This bill has still not become a law.
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45. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
Long bones
Retention of Medical Records
Medicare
Nonparticipating physician
46. - is a procedure or service provided without proper authorization or was not covered by a current authorization. The claim is denied and the provider cannot bill the patient for the charges.
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Limited ROM
Unauthorized benefit
Retention of Medical Records
47. 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
Assault
Remittance Advice
Zygoma
Spinal/Vertebral Column
48. Represent services and procedures widely used by many health care professionals in clinical practice in multiple locations and have been approved by the FDA.
Category I Codes CPT
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Employer Liability
Health practitioner
49. 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
Evaluation and Management Review
Ulcermembranes
Fee-for-Service
Coordination of Benefits (COB)
50. Small collection of clear fluid;blister
Short bones
Personal Insurance
Vesicle
Fissure