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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 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
HCPCS Level II codes (National Codes)
Subcategories
Tabular List (Volume 1)...
Spinal/Vertebral Column
2. numbers 8-10 - are attached to the sternum by cartilage
stand-alone codes
Reasons for Documentation
False ribs
Long bones
3. Are codes formulated thru the joint efforts of the CMS - the Health Insurance Association of America - and the Blue Cross and Blue Shield Association. Level II contains five position alpha-numeric codes for physician and non-physician services not fo
Wheal
HCPCS Level II codes (National Codes)
Hypertension Table
Mutually Exclusive Edits
4. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
There are two types of sweat glands
Medically needy
Sphenoid Bones
Add-on codes
5. Discolored - flat lesion (freckles - tattoo marks)
Nonparticipating physician
The Current Procedural Terminology (CPT)
Ethmoid Bone
Macule
6. 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
Abuse
Limited ROM
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Patient Confidentiality
7. This modifier is used when the same procedure is performed on a mirror-image part of the body..
Benign (hypertension)
-50 - Bilateral Procedure
False ribs
Vesicle
8. This modifier is used when the same procedure is performed on a mirror-image part of the body..
Full ROM
-50 - Bilateral Procedure
Nonparticipating physician
itemized statement
9. Any fracture occurring spontaneously as a result of disease.
Pathologic
Colles
bullet (a
Invalid claim
10. 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.
Musculoskeletal System
Humerus
Patient Confidentiality
Non-covered benefit
11. 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.
Clean claim
Fissure
Macule
Sections
12. Is the type of plan a patient may have where they can see providers outside their plan. The patient is responsible to pay the higher portion of the fee.
Evaluation and Management Review
Preferred Provider plan
Subcategories
False ribs
13. 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
Pathologic
Health Maintenance Organization (HMO)
The Patient Care Partnership (Patient's Bill of Rights)
Electronic Claim
14. Numbers 1-7 - attach directly to the sternum in the front of the body.
true ribs
Employee Liability
Lipocyte
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
15. 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.
Neoplasm Table
Disability insurance
Inpatient
Alphabetic Index (Volume 2)
16. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
The Good Samaritan Act
HCPCS Level I codes
Modifiers
Dirty claim
17. 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.
Alphabetic Index (Volume 2)
true ribs
Wheal
Add-on codes
18. male of household is primary payer
A plus sign (+)
Gender rule
Pre-authorization
TRICARE
19. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Chief complaint (CC)
Medical Records
False Claims Act (FCA)
Accept assignment
20. 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
Compliance Regulations
Capitated Rates
Outpatient
Ulcermembranes
21. Contains complete - necessary information - but is incorrect or illogical in some way.
Invalid claim
Assault
Physician
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
22. Is a requirement for some health insurance plans to obtain permission for a service or procedure before it is done. It indicates that a specific procedure or service is deemed 'medically necessary'.
Temporal Bone
Pre-authorization
axial skeleton
Benign
23. Are the main division in the ICD-9-CM; they are divided into sections. e.g.. - 3. Endocrine - Nutritional and Metabolic Diseases - and Immunity Disorders (240-279).
Pelvis
Chapters
Coinsurance
False Claims Act (FCA)
24. 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
Fiscal Intermediary
Civil Monetary Penalties Law (CMPL)
-51 - Multiple Procedures
Ischium
25. 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
The Integumentary System
Relative Value Payment Schedules Method
circle with a line through it)
New patient
26. In July 2001 - the Health Care Financing Administration (HCFA) became the Centers for Medicare & Medicaid Services (CMS) - and the universal claim form HCFA-1500 became the CMS-1500.Virtually all third-party payers will accept it - and Medicare requ
Unique Provider Identification Number (UPIN)
Retention of Medical Records
The Universal Claim Form
No ROM
27. 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
Established Patient
Fee Schedule
Ethmoid Bone
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
28. This is a set of information the physician gathers from the patient regarding the following:
Chief complaint
History
HCPCS Level II codes (National Codes)
Medical necessity
29. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
Rib Cage
Health Insurance Portability and Accountability Act (HIPAA)
ligaments
Personal Insurance
30. Most billing-related cases are based on HIPAA and False Claims Act.
Retention of Medical Records
Compliance Regulations
There are two types of sweat glands
Group Provider Number
31. the bone is crushed and or shattered.
HCPCS Level I codes
Comminuted fracture
The Integumentary System
Radius
32. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.
History of present illness (HPI)
Greenstick
Fee Schedule
Established patient
33. A chronological account of the development of the complaint from the first sign or symptom that the patient experienced to the present
Category III Codes CPT
History of present illness (HPI)
Nodule
Chief complaint (CC)
34. 'Errors and omissions insurance' is protection against loss of monies caused by failure through error or unintentional omission on the part of the individual or service submitting the insurance claim. Some physicians' contract with a billing service
Employee Liability
Zygoma
Impacted
Subcategories
35. The bone is broken and pierces an internal organ
Disability insurance
Compliance Regulations
Complicated
Macule
36. Is the upper arm bone.
Alphabetic Index (Volume 2)
Humerus
Performing Provider Identification Number (PPIN)
Modifiers
37. 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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38. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
Abuse
False Claims Act (FCA)
Maxilla
Impetigo
39. 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.
Pre-determination
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Category III Codes CPT
History
40. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.
Pre-certification
Liability insurance
Fissure
Melanin
41. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
Spinal/Vertebral Column
circle with a line through it)
Carcinoma (Ca) in situ
Qualified diagnosis
42. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
Nodule
No ROM
Primary malignancy
Categories
43. 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
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
MEDICARE Part B
Medicare
Unspecified (hypertension)
44. 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.'
Keratin
Medical necessity
Group practice
Coding
45. 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
Sesamoid bones
MEDICARE Part D
Unspecified (hypertension)
Outpatient
46. Is a working diagnosis which is not yet established.
Preferred Provider plan
Qualified diagnosis
Capitated Rates
Group Insurance
47. The cuticle at the lower part of the nail and this is sometimes referred to as the
History
eponychium
Albino
Collagen
48. To report a circumstance in which the physician returns to the operating room to address a complication stemming from the initial procedure - modifier -78 is attached to the subsequent procedure code.
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
itemized statement
Humerus
phalanges (phalanx.s)
49. Are codes formulated thru the joint efforts of the CMS - the Health Insurance Association of America - and the Blue Cross and Blue Shield Association. Level II contains five position alpha-numeric codes for physician and non-physician services not fo
Social Security Number
-50 - Bilateral Procedure
Health practitioner
HCPCS Level II codes (National Codes)
50. The epidermis - the dermis - and the subcutaneous layer. The epidermis is a thin - cellular membrane layer that contains keratin. The dermis is a dense - fibrous - connective tissue that contains collagen. The subcutaneous layer is a thicker and fatt
There are three layers to the skin
Category III Codes CPT
Pathologic
Alphabetic Index (Volume 2)