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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.
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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. Indicates add-on codes
Ischium
Health Maintenance Organization (HMO)
A plus sign (+)
HCPCS Level I codes
2. anterior to the temporal bones.
Nodule
TRICARE
Retention of Medical Records
Sphenoid Bones
3. This modifier is used when the same procedure is performed on a mirror-image part of the body..
Qualified diagnosis
Review of Systems (ROS)
History
-50 - Bilateral Procedure
4. When a group of employees and their dependents are insured under one (1) group policy issued to the employer. Generally - the employer pays the premium or a portion of the premium and the employee pays the difference. This all depends on the type of
Group Insurance
Preferred Provider Organization (PPO)
Chapters
Health Insurance Portability and Accountability Act (HIPAA)
5. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
Long bones
Chief complaint (CC)
Humerus
Group Insurance
6. 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).
State License Number
Non-covered benefit
Sections
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
7. 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
Sections
true ribs
-90 - Reference (Outside) Laboratory
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.
Nonparticipating physician
Flat bones
Medical Records
Fraud
9. 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
False ribs
premium
itemized statement
10. Is defined by Medicare as 'the determination that a service or procedure rendered is reasonable and necessary for the diagnosis or treatment of an illness or injury.'
Medical necessity
Parietal Bones
Workers Compensation
Past - family and social history (PFSH)
11. Cheekbone
The Integumentary System
Zygoma
Short bones
Coinsurance
12. 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 -
sprain
Disability insurance
Indemnity Insurance
Add-on codes
13. Bone that forms posterior/inferior part of the nasal septal wall between the nostrils.
Group Provider Number
Vomer
Medigap (Medicare Supplemental Insurance)
Ulcermembranes
14. 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.
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Maxilla
Medicaid
Paper Claim
15. Produce secretions that allow the body to be moisturized or cooled.
sebaceous(oil) glands and the suddoriferous (sweat) glands
Chief complaint
eponychium
Hairline
16. Cheekbone
Zygoma
Health Care Financing Administration Common Procedure Coding System
Dirty claim
Fissure
17. 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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18. 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
Retention of Medical Records
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
-26 - Professional Component
Chief complaint
19. This is the inventory of the constitutional symptoms regarding the various body systems.
Workers Compensation
Pelvis
Review of Systems (ROS)
Sections
20. Also called 'global surgery' - includes a variety of services rendered by a surgeon which includes the following: Surgical procedure performed Local infiltration - metacarpal/metatarsal/digital block - or topical anesthesia Preoperative E/M services
Surgical Package
Add-on codes
New patient
sprain
21. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Unspecified nature
Clean claim
Sphenoid Bones
Sebaceous glands
22. requires investigation and needs further clarification.
Unspecified (hypertension)
MEDICARE Part A
Fraud
Rejected claim
23. Deficient in pigment (melanin)
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Short bones
Full ROM
Albino
24. 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
stand-alone codes
Review of Systems (ROS)
Gender rule
Unlisted Procedures Procedures
25. The main term in the index may by followed by terms within parenthesis.
Primary malignancy
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Alphabetic Index (Volume 2)
Sphenoid 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.
Unauthorized benefit
Point-of-Service plan (POS)
Rejected claim
Rib Cage
27. 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
Outpatient
Short bones
CPT SECTIONS.
Commercial Carriers
28. A chronological account of the development of the complaint from the first sign or symptom that the patient experienced to the present
Accept assignment
Malignant
History of present illness (HPI)
phalanges (phalanx.s)
29. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
Malignant
Gender rule
Modifiers
Electronic Claim
30. This is a set of information the physician gathers from the patient regarding the following:
Fissure
Hypertension Table
Hairline
History
31. Structural protein found in the skin and connective tissue
Sebaceous glands
Collagen
-32 - Mandated Services
Radius
32. Number assigned by the insurance company to a physician who renders services to patients.
Remittance Advice
Vesicle
Unlisted Procedures Procedures
Provider Identification Number (PIN)
33. Standard - fee-for-service - cost-sharing plan ; Extra - preferred provider organization ;Prime - health maintenance organization plan with a point-of-service option All of the above-mentioned plans covered under TRICARE - with the exception of Prime
Physician
Pubic bone
TRICARE PLANS
Category I Codes CPT
34. open sore on the skin or mucous
MEDICARE Part A
Ulcermembranes
Dirty claim
eponychium
35. 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
Lipocyte
Colles
TRICARE PLANS
Birthday rule
36. The fractured area of bone collapses on itself.
Compression fracture
Short bones
Review of Systems (ROS)
Humerus
37. Is the lateral lower arm bone (in line with the thumb).
Alphabetic Index (Volume 2)
Indemnity Insurance
Two triangular symbols (a
Radius
38. 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.
Short bones
Albino
Benign (hypertension)
triangle (a
39. 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.
HCPCS Level I codes
State License Number
Medicaid
Secondary malignancy
40. A minor fracture appears as a thin line on x-ray and may not extend completely through the bone.
Collagen
Keratin
Hairline
axial skeleton
41. Is a document provided to a Medicare beneficiary by a provider prior to service being rendered letting the beneficiary know of his/her responsibility to pay if Medicare denies the claim.
Advance Beneficiary Notice
Established patient
Suicide Attempt
Electronic Claim
42. Represents a new procedure or service code added since the previous edition of the manual.
bullet (a
-26 - Professional Component
Temporal Bone
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
43. is a traumatic injury to a joint involving the soft tissue.
Parietal Bones
Health Maintenance Organization (HMO)
sprain
Exclusions and Limitations
44. 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
Assault
-51 - Multiple Procedures
Temporal Bone
45. The break of the distal end of the radius at the epiphysis often occurs when the patient has attempted to break his or her fall.
Sesamoid bones
Rejected claim
Colles
nonessential modifiers
46. Number assigned to the physician by Medicare program.
Unique Provider Identification Number (UPIN)
Rejected claim
Tabular List (Volume 1)...
lunula
47. This number is used instead of the individual physician's number for the performing provider who is a member of a group practice that submits claims to insurance companies under the group name.
Section 3 Index to External Causes of Injury (E codes)
Paper Claim
Group Provider Number
Full ROM
48. is referred to as Supplementary Medical Insurance (SMI). This coverage is a supplement to Part A - which covers medical expenses - clinical laboratory services - home health care - outpatient hospital treatment - blood - and ambulatory surgical serv
Secondary malignancy
triangle (a
Medical necessity
MEDICARE Part B
49. 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
Medigap (Medicare Supplemental Insurance)
Birthday rule
Advance Beneficiary Notice
Health practitioner
50. paired bones at the corner of each eye that cradle the tear ducts.
Qualified diagnosis
Lacrimal bones
upper appendicular skeleton
Ethmoid Bone
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