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Test your basic knowledge |
Medical Billing And Coding Vocab
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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. The physician must obtain this number in order to practice within a state.
State License Number
A plus sign (+)
Qualified diagnosis
Fee Schedule
2. 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
Inpatient
A plus sign (+)
nonessential modifiers
Fee-for-Service
3. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
Impacted
Impetigo
Unspecified (hypertension)
Point-of-Service plan (POS)
4. 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
Polyp
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Tabular List (Volume 1)...
Compression fracture
5. 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
Sub classification
MEDICARE Part A
Sebaceous glands
Medically needy
6. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Capitated Rates
Compliance Regulations
Coding
Sebaceous glands
7. anterior to the temporal bones.
premium
Provider Identification Number (PIN)
Sphenoid Bones
Point-of-Service plan (POS)
8. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
Deductible
Primary malignancy
Ulcermembranes
Ischium
9. 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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10. Represent changes in the text or definition between the triangles.
Electronic Claim
Chief complaint (CC)
Palatine bones
Two triangular symbols (a
11. 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.
Point-of-Service plan (POS)
Consultation
National Correct Coding Initiative (NCCI)
HCPCS Level I codes
12. 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.
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
-32 - Mandated Services
Two triangular symbols (a
False ribs
13. 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.
Inpatient
Remittance Advice
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
National Correct Coding Initiative (NCCI)
14. major skin pigment
Pre-determination
Melanin
-90 - Reference (Outside) Laboratory
False ribs
15. Prescription Drugs The Medicare Prescription Drug - Improvement - and Modernization Act enacted in December 2003 and began implementation in January 2006 where Medicare beneficiaries can enroll in the Medicare prescription drug plan. The beneficiari
bullet (a
Non-covered benefit
stand-alone codes
MEDICARE Part D
16. Poisoning was due to: Accidental overdose; Wrong substance taken; Accidents in use of drugs and biologicals; External causes of poisonings classifiable to 980-989 Therapeutic Use: instances when a correct substance properly taken is the cause of adve
Reasons for Documentation
Benign
Accident
HCPCS Level II codes (National Codes)
17. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Reasons for Documentation
circle with a line through it)
Accept assignment
Surgical Package
18. Eccrine sweat glands are the most common and the apocrine sweat glands that secrete an odorless sweat.
Primary malignancy
Pre-authorization
Employee Liability
There are two types of sweat glands
19. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.
Indemnity Insurance
Greenstick
History of present illness (HPI)
circle with a line through it)
20. This is the index for the E codes.It classifies - in alphabetical order - environmental events and other conditions as the cause of injury and other adverse effects.
-26 - Professional Component
Collagen
Sphenoid Bones
Section 3 Index to External Causes of Injury (E codes)
21. Are conditions - situations - and services not covered by the insurance carrier.
Categorically needy -MEDICAID
Long bones
ulna
Exclusions and Limitations
22. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.
Radius
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Sphenoid Bones
Participating physician
23. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
HCPCS Level II codes (National Codes)
Consultation
MEDICARE Part A
Full ROM
24. The moon like white area at the base of the nail.
Location Methods
Pelvis
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
lunula
25. 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
Uncertain behavior
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
co-payment
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
26. provides a five-digit code which gives the highest specificity of description to a condition. Use of it is mandatory if it is available. A code not reported to the full number of digits required is invalid. e.g. 240.01 Toxic diffuse goiter with thyr
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Medical Records
Sub classification
Spinal/Vertebral Column
27. Further classified as to primary - secondary - or carcinoma in situ.
Fee Schedule
Accident
Malignant
Invalid claim
28. 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)
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
co-payment
Group practice
Rejected claim
29. Noninvasive - non-spreading - nonmalignant
False ribs
Medicare
Remittance Advice
Benign
30. 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
Lacrimal bones
Clearinghouse
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
31. requires investigation and needs further clarification.
Collagen
Qualified diagnosis
Rejected claim
Electronic Claim
32. 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.
Location Methods
Paper Claim
-26 - Professional Component
MEDICAID COVERAGE
33. This is the inventory of the constitutional symptoms regarding the various body systems.
Unlisted Procedures Procedures
Uncertain behavior
Review of Systems (ROS)
stand-alone codes
34. This modifier is used to explain that the procedure or service done during a postoperative period was planned at the time of the original procedure. This is also used if a therapeutic procedure is performed because of the findings from a diagnostic p
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Add-on codes
Explanation of Benefits (EOB)
35. Benign growth extending from the surface of the mucous membrane
Polyp
Albino
Pre-certification
State License Number
36. open sore on the skin or mucous
The Good Samaritan Act
Ulcermembranes
Chapters
History
37. There are also terms indented two spaces to the right below the main term called subterms. These subterms are because they have bearing in the selection of the right code. Everything in the Index is listed by condition - that is - diagnosis - signs -
essential modifiers
triangle (a
Medicare Claim Status
Fraud
38.
Albino
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Health Care Financing Administration Common Procedure Coding System
Carcinoma (Ca) in situ
39. are composed of a group of three-digit categories representing a group of conditions or related conditions; they are divided into categories. e.g. . - Disorders of Thyroid Gland (240 - 246).
HCPCS Level I codes
Multigravida
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Sections
40. 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
Unspecified (hypertension)
Albino
Spinal/Vertebral Column
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
41. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Greenstick
Employer Identification Number (EIN)
Commercial Carriers
Colles
42. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
MEDICARE Part B
Patient Confidentiality
Preferred Provider Organization (PPO)
Carcinoma (Ca) in situ
43. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
MEDICARE Part B
eponychium
Keratin
Unspecified nature
44. major skin pigment
Ischium
Chief complaint (CC)
Melanin
CPT SECTIONS.
45. Lower portion of the pelvic bone
true ribs
Ethmoid Bone
Ischium
lunula
46. 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
Pre-certification
ligaments
Fiscal Intermediary
47. 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
Hairline
Hairline
MEDICARE Part D
Clearinghouse
48. Is a patient who receives treatment in any of the following settings: physician's office ;hospital clinic - emergency department - hospital same-day surgery unit - ambulatory surgical center ( patient is released within 23 hours) ;hospital admission
Medicare
Outpatient
Workers Compensation
MEDICARE Part C
49. Describes the services billed and includes a breakdown of how the payment is determined
Explanation of Benefits (EOB)
lunula
Fissure
Contracted Rates with MCOs
50. 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
Fee-for-Service
Alopecia
Health Care Financing Administration Common Procedure Coding System
Fissure