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. is defined as reimbursement for income lost as a result of a temporary or permanent illness or injury. When patients are treated for disability diagnoses and other medical problems - separate patient records must be maintained. Disability insurance
Pathologic
No ROM
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Disability insurance
2. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Mutually Exclusive Edits
Limited ROM
itemized statement
Unlisted Procedures Procedures
3. Number assigned to the physician by Medicare program.
Unique Provider Identification Number (UPIN)
Impacted
Gangrene
Gender rule
4. represents Exemption from the use of modifier -51
circle with a line through it)
Dirty claim
Greenstick
axial skeleton
5. 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
Assault
Capitated Rates
Abuse
Coding
6. Absence of hair from areas where it normally grows
Radius
Eligibility
A plus sign (+)
Alopecia
7. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
Categories
Carcinoma (Ca) in situ
Deductible
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
8. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
Social Security Number
Fee Schedule
Health Insurance Portability and Accountability Act (HIPAA)
Unlisted Procedures Procedures
9. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body
Clearinghouse
New patient
Secondary malignancy
sebaceous(oil) glands and the suddoriferous (sweat) glands
10. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
Medically needy
The Current Procedural Terminology (CPT)
Participating physician
Coordination of Benefits (COB)
11. Most billing-related cases are based on HIPAA and False Claims Act.
Compliance Regulations
Medigap (Medicare Supplemental Insurance)
Lipocyte
Categorically needy -MEDICAID
12. The moon like white area at the base of the nail.
bullet (a
Complicated
lunula
Disability insurance
13. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
Medicare
bullet (a
Impetigo
CPT SECTIONS.
14. Structural protein found in the skin and connective tissue
A plus sign (+)
New patient
Gangrene
Collagen
15. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
The Good Samaritan Act
Keratin
Group practice
Deductible
16. Provide a four-digit code (one digit after the decimal point) which is more specific than category code (3-digit) in terms of cause - site - or manifestation of the condition. This must be used if available. From subcategory - specificity moves to an
There are three layers to the skin
Suicide Attempt
Subcategories
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
17. 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
Rib Cage
Occipital Bone
Vomer
MEDICARE Part B
18. A minor fracture appears as a thin line on x-ray and may not extend completely through the bone.
Melanin
appendicular skeleton .
Hairline
Spinal/Vertebral Column
19. 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
Keratin
Health practitioner
ligaments
The St. Anthony Relative Value for Physicians (RVP)
20. 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.
Rejected claim
Clean claim
Lacrimal bones
The Current Procedural Terminology (CPT)
21. uncertain whether benign or malignant; borderline malignancy
Coordination of Benefits (COB)
Uncertain behavior
Salter-Harris
Category I Codes CPT
22. 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).
phalanges (phalanx.s)
Inpatient
Exclusions and Limitations
Sections
23. Groove or crack like sore
Fissure
Clean claim
-26 - Professional Component
Eligibility
24. uncertain whether benign or malignant; borderline malignancy
Health Care Financing Administration Common Procedure Coding System
Sub classification
Uncertain behavior
sebaceous(oil) glands and the suddoriferous (sweat) glands
25. Mild or controlled hypertension and no damage to the vascular system or organs.
No ROM
Benign (hypertension)
Clearinghouse
The Universal Claim Form
26. The Usual - Customary - and Reasonable: The UCR method is used mostly in reference to fee-for-service reimbursement. To arrive at a payment amount for a claim - the carrier compares: The physician's most frequent charge for a given service (the usual
co-payment
Ischium
Fee Schedule
Category I Codes CPT
27. This modifier is used to indicate that the procedure was done by an outside laboratory and not by the reporting facility or clinic.
-90 - Reference (Outside) Laboratory
Pre-authorization
Employee Liability
Frontal Bone
28. 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.
Categorically needy -MEDICAID
eponychium
Inpatient
Non-covered benefit
29. 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
Peer Review Organization (PRO)
Group Provider Number
Abuse
Accident
30. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body
Ischium
Secondary malignancy
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
31. 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
Mandible
Fraud
Liability insurance
Palatine bones
32. Poisoning cannot be determined whether intentional or accidental.
Medically needy
Gender rule
Neoplasm Table
Undetermined
33. Mild or controlled hypertension and no damage to the vascular system or organs.
Benign (hypertension)
Wheal
Inpatient
Exclusions and Limitations
34. 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
Exclusions and Limitations
Spinal/Vertebral Column
Established Patient
The Universal Claim Form
35. 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
Group Insurance
Location Methods
Occipital Bone
Multigravida
36. 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
Outpatient
Medical necessity
Parietal Bones
Surgical Package
37. Forms the sides of the cranium
Fraud
Coordination of Benefits (COB)
Health practitioner
Parietal Bones
38. 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
Pre-authorization
Frontal Bone
Benign (hypertension)
Unlisted Procedures Procedures
39. The cuticle at the lower part of the nail and this is sometimes referred to as the
eponychium
Retention of Medical Records
Category II Codes CPT
TRICARE
40. Is a managed care benefits plan that provides a wide range of medical services to individuals that have been enrolled into the program. It is generally the least costly but at the same time also the most restrictive. This plan uses a gatekeeper physi
Chief complaint (CC)
History
Health Maintenance Organization (HMO)
Deductible
41. 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
Employer Liability
Deductible
sprain
Medical Records
42. 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:
There are two types of sweat glands
Category II Codes CPT
Hypertension Table
Humerus
43. 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.
MEDICAID COVERAGE
phalanges (phalanx.s)
Fraud
Nonparticipating physician
44. 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
Sesamoid bones
Impacted
Neoplasm Table
appendicular skeleton .
45. Are supplementary classification codes used to describe the reason or external cause of injury - poisoning and other adverse effects. These codes can be found in both Volumes I and II. E codes are used to classify environmental events - circumstances
Comminuted fracture
true ribs
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
National Correct Coding Initiative (NCCI)
46. The physician must obtain this number in order to practice within a state.
TRICARE PLANS
State License Number
Rejected claim
Compliance Regulations
47. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
Wheal
Clean claim
Preferred Provider plan
The Universal Claim Form
48. are small with irregular shapes. They are found in the wrist and ankle.
Short bones
Palatine bones
Temporal Bone
The St. Anthony Relative Value for Physicians (RVP)
49. 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
Established Patient
Pre-paid Health Plan
Patient Confidentiality
upper appendicular skeleton
50. death of tissue associated with loss of blood supply
Health Maintenance Organization (HMO)
Outpatient
-26 - Professional Component
Gangrene