SUBJECTS
|
BROWSE
|
CAREER CENTER
|
POPULAR
|
JOIN
|
LOGIN
Business Skills
|
Soft Skills
|
Basic Literacy
|
Certifications
About
|
Help
|
Privacy
|
Terms
|
Email
Search
Test your basic knowledge |
Medical Billing And Coding Vocab
Start Test
Study First
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. 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
National Correct Coding Initiative (NCCI)
Suicide Attempt
Lipocyte
2. Most billing-related cases are based on HIPAA and False Claims Act.
Health practitioner
Compliance Regulations
Ischium
Comminuted fracture
3. numbers 8-10 - are attached to the sternum by cartilage
Radius
Coding
False ribs
Flat bones
4. anterior to the temporal bones.
Sphenoid Bones
Two triangular symbols (a
Limited ROM
Vomer
5. is defined as one who has not received any medical services within the last three years.
Non-covered benefit
Temporal Bone
New Patient
Sections
6. is a federal program administered by state governments to provide medical assistance to the needy. Each state sets its own guidelines for eligibility and services - therefore benefits and coverage may vary widely from state to state.
Medicaid
nonessential modifiers
Evaluation and Management Review
phalanges (phalanx.s)
7. Is one who has no contract with the health insurance plan.
Humerus
Gangrene
-90 - Reference (Outside) Laboratory
Nonparticipating physician
8. This is an alternative to paper claims submitted to the third-party payer directly by the physician or through a clearinghouse. Electronic claims are usually paid faster than paper claims and most electronic claims software have self-editing features
Compression fracture
MEDICARE Part A
New patient
Electronic Claim
9. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).
Suicide Attempt
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Coordination of Benefits (COB)
Temporal Bone
10. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
Musculoskeletal System
Frontal Bone
Inpatient
Long bones
11. Medicare Managed Care Plans (Formerly Medicare Plus (+) Choice Plan) was created to offer a number of healthcare services in addition to those available under Part A and Part B. The CMS contracts with managed care plans or provider service organizati
Temporal Bone
MEDICARE Part C
Benign (hypertension)
Electronic Claim
12. the bone is broken and the ends are driven into each other.
Location Methods
Impacted
Surgical Package
Occipital Bone
13. male of household is primary payer
Humerus
Compression fracture
Gender rule
Workers Compensation
14. Discolored - flat lesion (freckles - tattoo marks)
Macule
Qualified diagnosis
Ethmoid Bone
upper appendicular skeleton
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.
Health practitioner
Sphenoid Bones
Limited ROM
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
16. Number assigned to the physician by Medicare program.
Review of Systems (ROS)
Coordination of Benefits (COB)
Unique Provider Identification Number (UPIN)
Chapters
17. 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.
There are two types of sweat glands
Clean claim
Chief complaint
Accident
18. Make up part of the interior of the nose.
Established Patient
Blue Cross/Blue Shield Plans
Melanin
Inferior nasal conchae
19. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
Wheal
Two triangular symbols (a
Modifiers
bullet (a
20. 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
Ethmoid Bone
Uncertain behavior
Category I Codes CPT
Location Methods
21. 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
Reasons for Documentation
Sections
Deductible
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
22. 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
MEDICAID COVERAGE
itemized statement
Surgical Package
Undetermined
23. 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
Civil Monetary Penalties Law (CMPL)
-50 - Bilateral Procedure
Categorically needy -MEDICAID
24. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
Point-of-Service plan (POS)
Compliance Regulations
Medicare Claim Status
Deductible
25. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.
Frontal Bone
Category III Codes CPT
Greenstick
New patient
26. - 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
Chapters
Medigap (Medicare Supplemental Insurance)
Capitated Rates
HCPCS Level II codes (National Codes)
27. Upper jaw bone
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Medicare
itemized statement
Maxilla
28. A fat cell
Abuse
Lipocyte
Fiscal Intermediary
encounter form
29. This is an alternative to paper claims submitted to the third-party payer directly by the physician or through a clearinghouse. Electronic claims are usually paid faster than paper claims and most electronic claims software have self-editing features
Nodule
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Category I Codes CPT
Electronic Claim
30. Law passed by the federal government to prosecute cases of Medicaid fraud.
New patient
Civil Monetary Penalties Law (CMPL)
MEDICARE Part C
CPT SECTIONS.
31. - 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.
Advance Beneficiary Notice
Abuse
Unauthorized benefit
phalanges (phalanx.s)
32. This is also known as fee-for-service. Under this plan - the services that are paid for are listed in the policy and payments are based on the fees physicians charge for the service. Each year - the beneficiary must meet a deductible - after which -
Indemnity Insurance
No ROM
Two triangular symbols (a
Exclusions and Limitations
33. Superior and widest bone
MEDICARE Part A
Category III Codes CPT
Pelvis
A plus sign (+)
34. Represent changes in the text or definition between the triangles.
Two triangular symbols (a
Polyp
Past - family and social history (PFSH)
Humerus
35. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients
Section 3 Index to External Causes of Injury (E codes)
HCPCS Level I codes
Nodule
Modifiers
36. is basically the same as HMO in the sense that the health care provider enters into contract with the MCOs to render services to the beneficiaries. However - PPO's charge a higher premium than HMO's in exchange for more flexibility and more options
Preferred Provider Organization (PPO)
New patient
triangle (a
premium
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.
Maxilla
Exclusions and Limitations
TRICARE PLANS
Non-covered benefit
38. 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
False Claims Act (FCA)
Commercial Carriers
The Integumentary System
Subcategories
39. Most procedures have both professional (physician) and technical components. This modifier is attached to the procedure to indicate that the physician provided only the professional component.
Radius
-51 - Multiple Procedures
Palatine bones
-26 - Professional Component
40. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.
MEDICARE Part C
encounter form
Surgical Package
Macule
41. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
Fee-for-Service
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Impetigo
Limited ROM
42. Law passed by the federal government to prosecute cases of Medicaid fraud.
Qualified diagnosis
Categories
Civil Monetary Penalties Law (CMPL)
Greenstick
43. is a federal program administered by state governments to provide medical assistance to the needy. Each state sets its own guidelines for eligibility and services - therefore benefits and coverage may vary widely from state to state.
Clean claim
No ROM
Coinsurance
Medicaid
44. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
Carcinoma (Ca) in situ
Pre-certification
Sesamoid bones
Health practitioner
45. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Commercial Carriers
Pre-certification
Accept assignment
National Correct Coding Initiative (NCCI)
46. 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.
Pre-paid Health Plan
triangle (a
National Correct Coding Initiative (NCCI)
Health practitioner
47. Are temporary codes for emerging technology - services and procedures. If a Category III code is available - it is reported instead of a Category I unlisted code.
Workers Compensation
The Universal Claim Form
Category III Codes CPT
Primary malignancy
48. Produce secretions that allow the body to be moisturized or cooled.
stand-alone codes
The Good Samaritan Act
There are three layers to the skin
sebaceous(oil) glands and the suddoriferous (sweat) glands
49. Cheekbone
Zygoma
Sub classification
Established Patient
Provider Identification Number (PIN)
50. 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.
Parietal Bones
Invalid claim
Add-on codes
Coding