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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. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the
Abuse
MEDICARE Part A
Capitated Rates
Neoplasm Table
2. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
Rib Cage
Invalid claim
Patient Confidentiality
New Patient
3. Provide the means by which the reporting physician can indicate that a service or procedure that has been performed has been altered by some specific circumstance but not changed in its definition or code.
true ribs
Benign
Modifiers
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
4. 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.
Medigap (Medicare Supplemental Insurance)
Colles
Category I Codes CPT
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
5. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
sebaceous(oil) glands and the suddoriferous (sweat) glands
Pre-determination
Coding
co-payment
6. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.
Limited ROM
Pelvis
Salter-Harris
Keratin
7. 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.
The Universal Claim Form
Medicare Claim Status
Salter-Harris
Colles
8. 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
nonessential modifiers
HCPCS Level II codes (National Codes)
Surgical Package
Polyp
9. Are conditions - situations - and services not covered by the insurance carrier.
-32 - Mandated Services
Malignant
No ROM
Exclusions and Limitations
10. poisoning was inflicted by another person with intent to kill or injure
Pre-determination
TRICARE
Assault
Unique Provider Identification Number (UPIN)
11. Is the lower medial arm bone.
Ischium
ulna
Fee-for-Service
Reasons for Documentation
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
National Correct Coding Initiative (NCCI)
Rejected claim
The Current Procedural Terminology (CPT)
Vesicle
13.
-50 - Bilateral Procedure
Macule
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Blue Cross/Blue Shield Plans
14. Make up part of the interior of the nose.
Clean claim
Inferior nasal conchae
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Benign (hypertension)
15. This modifier is used to indicate that the procedure or service provided during the postoperative period was not associated with the initial procedure. Payment for the full fee of the subsequent procedure is requested and a new global period starts.
Inpatient
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Established Patient
16. death of tissue associated with loss of blood supply
Short bones
No ROM
MEDICARE Part B
Gangrene
17. 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.
Colles
Medical Records
Vesicle
The St. Anthony Relative Value for Physicians (RVP)
18. Any fracture occurring spontaneously as a result of disease.
Pathologic
Complicated
State License Number
Wheal
19. 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.
Secondary malignancy
Retention of Medical Records
Category II Codes CPT
Ulcermembranes
20. 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
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
There are three layers to the skin
Outpatient
MEDICAID COVERAGE
21. This is not specified as benign or malignant in the diagnosis or medical record.
Categorically needy -MEDICAID
Benign (hypertension)
Unspecified (hypertension)
Workers Compensation
22. Indicates add-on codes
HCPCS Level II codes (National Codes)
Tabular List (Volume 1)...
False Claims Act (FCA)
A plus sign (+)
23. An insurance plan issued to an individual. Premium rates are usually higher than group rates and service availability is lessened with this type of coverage.
Albino
Personal Insurance
Impacted
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
24. are small with irregular shapes. They are found in the wrist and ankle.
Short bones
Non-covered benefit
New Patient
Chief complaint (CC)
25. the bone is broken and the ends are driven into each other.
upper appendicular skeleton
Impacted
circle with a line through it)
Malignant
26. Discolored - flat lesion (freckles - tattoo marks)
Macule
TRICARE PLANS
Health Care Financing Administration Common Procedure Coding System
Paper Claim
27. The main term in the index may by followed by terms within parenthesis.
History of present illness (HPI)
Alphabetic Index (Volume 2)
Occipital Bone
Workers Compensation
28. most synarthroses are immovable joints held together by fibrous tissue.
Gangrene
Evaluation and Management Review
No ROM
HCPCS Level I codes
29. 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
False Claims Act (FCA)
Occipital Bone
Two triangular symbols (a
circle with a line through it)
30. 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
Modifiers
Health practitioner
The Universal Claim Form
Physician
31. Produce secretions that allow the body to be moisturized or cooled.
Comminuted fracture
Medigap (Medicare Supplemental Insurance)
False Claims Act (FCA)
sebaceous(oil) glands and the suddoriferous (sweat) glands
32. Further classified as to primary - secondary - or carcinoma in situ.
Malignant
Pre-paid Health Plan
Two triangular symbols (a
Contracted Rates with MCOs
33. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
ligaments
Fraud
Occipital Bone
Carcinoma (Ca) in situ
34. open sore on the skin or mucous
Medical Records
Limited ROM
Ulcermembranes
Medigap (Medicare Supplemental Insurance)
35. 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
Electronic Claim
Medicare
Social Security Number
Ulcermembranes
36. 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
The Good Samaritan Act
There are two types of sweat glands
There are three layers to the skin
Clearinghouse
37. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
Uncertain behavior
axial skeleton
MEDICARE Part C
Rib Cage
38. Has all required fields accurately filled out - contains no deficiencies and passes all edits. The carrier does not require investigation outside of the carrier's operation before paying the claim.
Non-covered benefit
Pre-determination
Unlisted Procedures Procedures
Clean claim
39. requires investigation and needs further clarification.
Rejected claim
sprain
Pre-determination
Inpatient
40. numbers 8-10 - are attached to the sternum by cartilage
Sections
False ribs
Pre-determination
Provider Identification Number (PIN)
41. Pre-determined set of benefits covered under one set annual fee.
lunula
Pre-paid Health Plan
Melanin
Explanation of Benefits (EOB)
42. Is one who has no contract with the health insurance plan.
premium
Nonparticipating physician
Melanin
Rejected claim
43. Is a working diagnosis which is not yet established.
Health practitioner
Qualified diagnosis
TRICARE
Remittance Advice
44. 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
TRICARE PLANS
Evaluation and Management Review
bullet (a
Fee Schedule
45. 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
Health Insurance Portability and Accountability Act (HIPAA)
-26 - Professional Component
Non-covered benefit
Fraud
46. 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
Group Provider Number
Radius
Medicare
Location Methods
47. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Birthday rule
Medigap (Medicare Supplemental Insurance)
Malignant
Employer Identification Number (EIN)
48. Groove or crack like sore
Review of Systems (ROS)
Fissure
Medical necessity
Medical Records
49. The poisoning was self-inflicted.
Suicide Attempt
MEDICARE Part D
Tabular List (Volume 1)...
Location Methods
50. Contains complete - necessary information - but is incorrect or illogical in some way.
Mutually Exclusive Edits
The Good Samaritan Act
Rib Cage
Invalid claim