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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. 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
true ribs
Vomer
National Correct Coding Initiative (NCCI)
Fraud
2. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
Exclusions and Limitations
The Good Samaritan Act
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Chief complaint (CC)
3. 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
HCPCS Level II codes (National Codes)
Secondary malignancy
Medicare Claim Status
circle with a line through it)
4. A fat cell
Subcategories
Lipocyte
Categorically needy -MEDICAID
triangle (a
5. 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:
Reasons for Documentation
National Correct Coding Initiative (NCCI)
Hypertension Table
Liability insurance
6. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Employer Identification Number (EIN)
lunula
Sphenoid Bones
The St. Anthony Relative Value for Physicians (RVP)
7. Is the lower medial arm bone.
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Alphabetic Index (Volume 2)
Fee-for-Service
ulna
8. Is an entity that receives transmissions of claims from physicians' offices - separates the claims by carriers and performs software edits on each claim to check for errors. Once this process is complete - the claim is then sent to the proper insuran
Unlisted Procedures Procedures
TRICARE
Lipocyte
Clearinghouse
9. Is a statement of the patient's account history - showing dates of service - detailed charges - payments (i.e. deductibles and co-pays) - the date the insurance claim was submitted - applicable adjustments and account balance.
State License Number
itemized statement
Limited ROM
-51 - Multiple Procedures
10. 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.
Hypertension Table
Short bones
Inpatient
Tabular List (Volume 1)...
11. 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
The Patient Care Partnership (Patient's Bill of Rights)
Medicare Claim Status
Birthday rule
Liability insurance
12. 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.
Sphenoid Bones
Impetigo
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Clean claim
13. Eccrine sweat glands are the most common and the apocrine sweat glands that secrete an odorless sweat.
Complicated
Hairline
The Good Samaritan Act
There are two types of sweat glands
14. The physician must obtain this number in order to practice within a state.
Relative Value Payment Schedules Method
State License Number
Accept assignment
Accident
15. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.
stand-alone codes
Maxilla
Advance Beneficiary Notice
Greenstick
16. forms the roof of the nasal cavity.
Peer Review Organization (PRO)
Categories
There are two types of sweat glands
Ethmoid Bone
17. 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.
State License Number
Physician
New patient
Category I Codes CPT
18. 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.
Retention of Medical Records
Review of Systems (ROS)
Wheal
Long bones
19. The poisoning was self-inflicted.
Suicide Attempt
Pubic bone
Complicated
TRICARE
20. The moon like white area at the base of the nail.
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
-50 - Bilateral Procedure
lunula
New patient
21. the bone is crushed and or shattered.
Comminuted fracture
Impacted
Ulcermembranes
premium
22. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
Eligibility
Section 3 Index to External Causes of Injury (E codes)
Malignant
Modifiers
23. 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
Clearinghouse
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Group Insurance
Fee Schedule
24. This is not specified as benign or malignant in the diagnosis or medical record.
The Good Samaritan Act
Eligibility
Unspecified (hypertension)
-32 - Mandated Services
25. Represent changes in the text or definition between the triangles.
Two triangular symbols (a
Undetermined
Group Provider Number
Palatine bones
26. - 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.
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Unauthorized benefit
The St. Anthony Relative Value for Physicians (RVP)
Accept assignment
27. A physician has a separate PPIN for each group office/clinic in which he or she practices. In the Medicare program - in addition to a group number - each member of a group is issued an 8-character performing provider identification number.
triangle (a
Performing Provider Identification Number (PPIN)
Compression fracture
Employer Identification Number (EIN)
28. 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
Chief complaint
The Current Procedural Terminology (CPT)
Preferred Provider plan
Flat bones
29. All patients have a right to privacy and all information should remain privileged. Discuss patient information only with the patient's physician or office personnel that need certain information to do their job. Obtain a signed consent form to releas
Patient Confidentiality
Sesamoid bones
Lacrimal bones
Chief complaint
30. Is when two insurance companies work together to coordinate payment of the benefits.
Abuse
Coordination of Benefits (COB)
-50 - Bilateral Procedure
Nodule
31. make up part of the roof of the mouth
Location Methods
Impetigo
Ulcermembranes
Palatine bones
32. Families - pregnant women - and children ;Aid to Families with Dependent Children (AFDC)-related groups ;Non-AFDC pregnant women and children;Aged and disabled persons ;Supplemental Security Income (SSI)-related groups ;Qualified Medicare Beneficiari
Pelvis
Categorically needy -MEDICAID
Established Patient
Capitated Rates
33. 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
TRICARE
Compression fracture
Preferred Provider plan
Remittance Advice
34. most synarthroses are immovable joints held together by fibrous tissue.
Medigap (Medicare Supplemental Insurance)
No ROM
Wheal
There are three layers to the skin
35. Poisoning cannot be determined whether intentional or accidental.
Accept assignment
Complicated
Spinal/Vertebral Column
Undetermined
36. This modifier is used when: more than one procedure is performed during the same surgical episode; one code does not describe all of the procedures performed; and the secondary procedure is not minor or incidental to the major procedure. The followin
Pre-certification
The Universal Claim Form
Surgical Package
-51 - Multiple Procedures
37. 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
ligaments
Radius
Wheal
Gender rule
38. The CPT manual is composed of eight sections. Each section begins with guidelines that provide specific coding rules for that section. Guidelines at the beginning of the section are applicable to all codes in the section - while notes that pertain t
Alphabetic Index (Volume 2)
Inpatient
Civil Monetary Penalties Law (CMPL)
CPT SECTIONS.
39. This is used to indicate that the service provided was required by a third-party payer - governmental - legislative - or regulatory body. This does not include second opinion requested by a patient - family member - or another physician.
-32 - Mandated Services
Remittance Advice
Compliance Regulations
lunula
40. Noninvasive - non-spreading - nonmalignant
Paper Claim
Temporal Bone
Subcategories
Benign
41. Are the finger bones. Each finger has three phalanges - except for the thumb. The three phalanges are the proximal - middle and a distal phalanx. The thumb has a proximal and distal.
phalanges (phalanx.s)
Assault
Two triangular symbols (a
-51 - Multiple Procedures
42. This modifier is used when the same procedure is performed on a mirror-image part of the body..
true ribs
Carcinoma (Ca) in situ
-50 - Bilateral Procedure
Greenstick
43. This is not specified as benign or malignant in the diagnosis or medical record.
Unspecified (hypertension)
Employer Identification Number (EIN)
Ischium
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
44. Is to determine the patient's benefits and the maximum dollar amount that the insurance company will pay. Often the first step of the insurance verification process - it is completed prior to the first visit.
Parietal Bones
Pre-determination
Melanin
Carcinoma (Ca) in situ
45. Are the main division in the ICD-9-CM; they are divided into sections. e.g.. - 3. Endocrine - Nutritional and Metabolic Diseases - and Immunity Disorders (240-279).
Chapters
Evaluation and Management Review
Mutually Exclusive Edits
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
46. 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
MEDICAID COVERAGE
Reasons for Documentation
Evaluation and Management Review
Category I Codes CPT
47. male of household is primary payer
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Medicaid
Gender rule
MEDICARE Part C
48. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
State License Number
Full ROM
Review of Systems (ROS)
Outpatient
49. Represents a change in the code description since the last edition. The change may be minor or significant and it could be an addition - deletion or revision.
triangle (a
Sebaceous glands
Consultation
Collagen
50. '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
Employee Liability
-51 - Multiple Procedures
Unspecified nature
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period