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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. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
Full ROM
Complicated
Vesicle
Sections
2. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
Past - family and social history (PFSH)
Pre-determination
Long bones
Medically needy
3. 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
circle with a line through it)
Ethmoid Bone
Nonparticipating physician
MEDICARE Part D
4. They are for profit organizations that operate in the private sector selling different health insurance benefits plans to groups or individuals. Most commercial plans have predefined patient yearly deductibles and coinsurance generally based on 80/2
National Correct Coding Initiative (NCCI)
Impacted
Commercial Carriers
The Patient Care Partnership (Patient's Bill of Rights)
5. 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
Section 3 Index to External Causes of Injury (E codes)
Occipital Bone
Hairline
Nodule
6. 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
Rib Cage
Disability insurance
Participating physician
-51 - Multiple Procedures
7. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Pre-determination
Vesicle
Preferred Provider Organization (PPO)
Chief complaint
8. 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.
Point-of-Service plan (POS)
Hairline
MEDICARE Part C
Medical Records
9. This is located in the Index under the main term 'Neoplasm' and is organized by anatomic site. Each site has six columns with six possible codes determined by whether the neoplasm is malignant - benign - of uncertain behavior - or of unspecified natu
Humerus
Neoplasm Table
Carcinoma (Ca) in situ
Medically needy
10. Make up part of the interior of the nose.
Zygoma
Salter-Harris
Location Methods
Inferior nasal conchae
11. Are composed of three-digit codes representing a single disease or condition.
Mutually Exclusive Edits
Categories
Chief complaint (CC)
Exclusions and Limitations
12. Is the upper arm bone.
Past - family and social history (PFSH)
Humerus
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Fissure
13. The moon like white area at the base of the nail.
encounter form
Limited ROM
Albino
lunula
14. 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.
Sesamoid bones
Add-on codes
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
15. This modifier is used to report a procedure or service that has more than one Modifier but the third-party payer does not allow the addition of multiple modifiers to the code. Modifier -99 is attached to the procedure code and the multiple Modifiers
Vomer
-99 - Multiple Modifiers
Inpatient
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
16. This is the traditional method used by providers for submission of charges to insurance companies. The most commonly used form is the CMS-1500. Few plans still accept the physician's encounter form or superbill and Medicare will only accept claims on
Paper Claim
Blue Cross/Blue Shield Plans
Peer Review Organization (PRO)
Polyp
17. consists of 17 chapters based on either body system or cause or type of disease. The codes range from 001-999.
Chapters
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Abuse
Tabular List (Volume 1)...
18. Represent changes in the text or definition between the triangles.
ligaments
Outpatient
Lacrimal bones
Two triangular symbols (a
19. 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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20. Benign growth extending from the surface of the mucous membrane
Impacted
Polyp
Blue Cross/Blue Shield Plans
Uncertain behavior
21. 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
Two triangular symbols (a
co-payment
Melanin
Location Methods
22. Make up part of the interior of the nose.
Established Patient
Inferior nasal conchae
Parietal Bones
Established Patient
23. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
Carcinoma (Ca) in situ
Medicaid
Greenstick
Pubic bone
24. Pre-determined set of benefits covered under one set annual fee.
Remittance Advice
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
sebaceous(oil) glands and the suddoriferous (sweat) glands
Pre-paid Health Plan
25. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Location Methods
Commercial Carriers
Employer Identification Number (EIN)
Gender rule
26. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.
Employer Liability
Participating physician
Review of Systems (ROS)
Long bones
27. This is a set of information the physician gathers from the patient regarding the following:
The Good Samaritan Act
History
Vomer
-51 - Multiple Procedures
28. Includes - but is not limited to - physician assistant - certified nurse-midwife - qualified psychologist - nurse practitioner - clinical social worker - physical therapist - occupational therapist - respiratory therapist - certified registered nurse
Pre-determination
Vesicle
Review of Systems (ROS)
Health practitioner
29. Produce secretions that allow the body to be moisturized or cooled.
Maxilla
Macule
sebaceous(oil) glands and the suddoriferous (sweat) glands
-51 - Multiple Procedures
30. includes the shoulder girdle which is made up of the scapula - clavicle and upper extremities. The scapula - or shoulder blades are flat bones that help support the arms. The clavicle - or collarbone - is curved horizontal bones that attach to the u
Temporal Bone
Accept assignment
Provider Identification Number (PIN)
upper appendicular skeleton
31. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).
nonessential modifiers
MEDICARE Part A
Column 1/Column 2 (previously called Comprehensive/Component) Edits
HCPCS Level I codes
32. 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
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Exclusions and Limitations
phalanges (phalanx.s)
33. The plan of the parent whose birthday falls earlier in the year (month and day - not year) is primary to that whose birthday falls later in the year. If both parents have the same birthday - then the plan of the parent who has had the longest coverag
Category II Codes CPT
Vesicle
Subcategories
Birthday rule
34. 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:
Personal Insurance
Humerus
Collagen
Hypertension Table
35. 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.
Invalid claim
Provider Identification Number (PIN)
Preferred Provider Organization (PPO)
National Correct Coding Initiative (NCCI)
36. This is the traditional method used by providers for submission of charges to insurance companies. The most commonly used form is the CMS-1500. Few plans still accept the physician's encounter form or superbill and Medicare will only accept claims on
essential modifiers
Paper Claim
Group Provider Number
Chief complaint
37. 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.
Full ROM
Section 3 Index to External Causes of Injury (E codes)
Vesicle
Column 1/Column 2 (previously called Comprehensive/Component) Edits
38. 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.
Surgical Package
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Retention of Medical Records
Lacrimal bones
39. is defined as one who has not received any medical services within the last three years.
Contracted Rates with MCOs
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
New Patient
Pathologic
40. 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
Preferred Provider plan
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
False Claims Act (FCA)
appendicular skeleton .
41. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.
encounter form
Relative Value Payment Schedules Method
-50 - Bilateral Procedure
Health practitioner
42. Poisoning cannot be determined whether intentional or accidental.
Undetermined
Electronic Claim
Outpatient
Outpatient
43. A fracture of the epiphyseal plate in children.
Performing Provider Identification Number (PPIN)
The Current Procedural Terminology (CPT)
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Salter-Harris
44. forms the roof of the nasal cavity.
The Patient Care Partnership (Patient's Bill of Rights)
Ethmoid Bone
Workers Compensation
Physician
45. Contain the full description of the procedure for the code indented codes: these are codes listed under associated stand-alone codes. To complete the description for indented codes - one must refer to the portion of the stand alone code description b
stand-alone codes
Pathologic
lunula
Physician
46. is a traumatic injury to a joint involving the soft tissue.
Full ROM
Vomer
Medical necessity
sprain
47. includes the shoulder girdle which is made up of the scapula - clavicle and upper extremities. The scapula - or shoulder blades are flat bones that help support the arms. The clavicle - or collarbone - is curved horizontal bones that attach to the u
Outpatient
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Ethmoid Bone
upper appendicular skeleton
48. This consists of the patient's personal experiences with illnesses - surgeries and injuries. It also contains information of illnesses predominant in the family. It contains the patient's educational background - occupation - marital status - and oth
Past - family and social history (PFSH)
Radius
Spinal/Vertebral Column
eponychium
49. death of tissue associated with loss of blood supply
Radius
Location Methods
Gangrene
Carpals
50. Forms the sides of the cranium
MEDICAID COVERAGE
Pelvis
Ulcermembranes
Parietal Bones