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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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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. The cuticle at the lower part of the nail and this is sometimes referred to as the
Employer Liability
Malignant
eponychium
Medigap (Medicare Supplemental Insurance)
2. 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
MEDICARE Part A
Benign (hypertension)
MEDICARE Part C
3. Bone that forms posterior/inferior part of the nasal septal wall between the nostrils.
Abuse
Vomer
False ribs
Chief complaint
4. 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)
stand-alone codes
Performing Provider Identification Number (PPIN)
Retention of Medical Records
co-payment
5. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Long bones
Inferior nasal conchae
Health Maintenance Organization (HMO)
6. Deficient in pigment (melanin)
Albino
Capitated Rates
MEDICARE Part B
Chapters
7. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Radius
Location Methods
Temporal Bone
Mutually Exclusive Edits
8. poisoning was inflicted by another person with intent to kill or injure
Vomer
The Good Samaritan Act
Ethmoid Bone
Assault
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
Occipital Bone
MEDICARE Part D
TRICARE
Short bones
10. 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.
Medical necessity
Carpals
Unique Provider Identification Number (UPIN)
nonessential modifiers
11. 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.
Carpals
MEDICARE Part C
Birthday rule
Deductible
12. Are a group of independently licensed local companies - usually nonprofit that contracts with physicians and other health entities to provide services to their insured companies and individuals. Most BC/BS plans offer HMO's - PPO's and POS plans. Blu
Peer Review Organization (PRO)
Fiscal Intermediary
Blue Cross/Blue Shield Plans
Pre-determination
13. Deficient in pigment (melanin)
Health practitioner
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Albino
Subcategories
14. Consists of the skull - rib cage - and spine
Section 3 Index to External Causes of Injury (E codes)
Rejected claim
axial skeleton
Patient Confidentiality
15. Under this schedule - a procedure's relative value is the sum total of three elements: Work: represents the amount of time - intensity of effort - and medical skill required of the physician. Overhead: practice costs related to the performing of the
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16. Various terms are used to describe the state of submitted forms. The following are some of the terms that are typically used by insurance carriers.
New patient
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Fiscal Intermediary
Medicare Claim Status
17. 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.
Ulcermembranes
Colles
Clearinghouse
The Good Samaritan Act
18. paired bones at the corner of each eye that cradle the tear ducts.
Lacrimal bones
HCPCS Level II codes (National Codes)
Colles
Greenstick
19. Considered experimental - newly approved - or seldom used may not be listed in the CPT manual. These codes can be coded as unlisted procedures. They are located at the end of the subsections or subheadings. When an unlisted procedure code is reported
Unlisted Procedures Procedures
Suicide Attempt
nonessential modifiers
Paper Claim
20. Cheekbone
Inpatient
The Good Samaritan Act
Ulcermembranes
Zygoma
21. Describes the services billed and includes a breakdown of how the payment is determined
Benign (hypertension)
Explanation of Benefits (EOB)
Uncertain behavior
Unspecified nature
22. 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
-50 - Bilateral Procedure
Unauthorized benefit
The Integumentary System
Malignant
23. Is a regionally managed healthcare program for active duty and retired members of the armed forces - their families - and survivors. It is a service benefit program and contains no premium. TRICARE is the new title for the CHAMPUS program (Civilian H
Health Care Financing Administration Common Procedure Coding System
Inferior nasal conchae
TRICARE
Fee-for-Service
24. the bone is crushed and or shattered.
-90 - Reference (Outside) Laboratory
Malignant
Medigap (Medicare Supplemental Insurance)
Comminuted fracture
25. is one who has not received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years.
New patient
encounter form
Palatine bones
Sebaceous glands
26. Typically not used on the claim form unless the provider does not have an EIN.
Collagen
Carpals
Social Security Number
Limited ROM
27. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
Flat bones
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
State License Number
Surgical Package
28. 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.
Modifiers
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Wheal
Unspecified (hypertension)
29. Physicians are legally responsible for their own conduct and any actions of their employees (their designee) performed within the context of their employment. This is referred to as 'vicarious liability -' also known as 'respondent superior -' which
HCPCS Level I codes
Employer Liability
eponychium
There are three layers to the skin
30. Under capitation - the physician provides a full range of contracted services to covered patients for a fixed amount on a periodic basis. While guaranteed a fixed amount - the physician assumes the risk that the cost of providing the care to the pati
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Non-covered benefit
Capitated Rates
Accident
31.
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Alphabetic Index (Volume 2)
Physician
Patient Confidentiality
32. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
Wheal
Unspecified (hypertension)
Liability insurance
Pathologic
33. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
Subcategories
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Malignant
Vomer
34. 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.
stand-alone codes
Category II Codes CPT
Group Provider Number
Provider Identification Number (PIN)
35. Forms the anterior part of the skull and the forehead
Birthday rule
Sections
Frontal Bone
Category II Codes CPT
36. This is the inventory of the constitutional symptoms regarding the various body systems.
False Claims Act (FCA)
No ROM
Review of Systems (ROS)
Civil Monetary Penalties Law (CMPL)
37. This is any procedure or service reported on the insurance claim that is not listed in the payer's master benefit list. This will result in the denial of the claim. Providers may be able to recover the charges from the patient.
Unspecified nature
The Integumentary System
Non-covered benefit
premium
38. Law passed by the federal government to prosecute cases of Medicaid fraud.
triangle (a
Blue Cross/Blue Shield Plans
Civil Monetary Penalties Law (CMPL)
Past - family and social history (PFSH)
39. is one who has not received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years.
New patient
CPT SECTIONS.
Health Maintenance Organization (HMO)
Unlisted Procedures Procedures
40. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Inferior nasal conchae
Category III Codes CPT
Social Security Number
Accept assignment
41. Was created to provide medical benefits to spouses and children of veterans with total - permanent service related disabilities or for surviving spouses and children of a veteran who died as a result of service-related disability. It is a service ben
upper appendicular skeleton
sprain
Chief complaint
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
42. is defined as one who has not received any medical services within the last three years.
Hairline
New Patient
Coding
Lacrimal bones
43. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).
Modifiers
Flat bones
appendicular skeleton .
Column 1/Column 2 (previously called Comprehensive/Component) Edits
44. Are supplementary classification codes used to identify health care encounters that occur for reasons other than illness or injury or to identify patients whose illness is influenced by special circumstances or problems. The codes can be found in bot
The Patient Care Partnership (Patient's Bill of Rights)
-26 - Professional Component
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Outpatient
45. Is one who has no contract with the health insurance plan.
Nonparticipating physician
Temporal Bone
Coordination of Benefits (COB)
-26 - Professional Component
46. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.
Fee-for-Service
Contracted Rates with MCOs
Ethmoid Bone
Limited ROM
47. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Suicide Attempt
Chief complaint
Pre-certification
essential modifiers
48. Any fracture occurring spontaneously as a result of disease.
phalanges (phalanx.s)
Pathologic
Musculoskeletal System
Malignant
49. The bone is broken and pierces an internal organ
Complicated
Categories
Benign
Assault
50. Make up part of the interior of the nose.
Inferior nasal conchae
Electronic Claim
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Hairline