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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
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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. Are small - rounded bones that resemble a sesame seed. They are found near joints and increase the efficiency of muscles near a joint. An example of sesamoid bone is the knee cap.
Medigap (Medicare Supplemental Insurance)
Health Care Financing Administration Common Procedure Coding System
Sesamoid bones
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
2. The bone is broken and pierces an internal organ
Complicated
There are two types of sweat glands
Spinal/Vertebral Column
The Patient Care Partnership (Patient's Bill of Rights)
3. 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)
Birthday rule
The Patient Care Partnership (Patient's Bill of Rights)
Primary malignancy
4. paired bones at the corner of each eye that cradle the tear ducts.
Pubic bone
Short bones
Participating physician
Lacrimal bones
5. Deficient in pigment (melanin)
Albino
The Integumentary System
-51 - Multiple Procedures
Preferred Provider Organization (PPO)
6. The moon like white area at the base of the nail.
Medigap (Medicare Supplemental Insurance)
sebaceous(oil) glands and the suddoriferous (sweat) glands
-99 - Multiple Modifiers
lunula
7. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
ligaments
Salter-Harris
Primary malignancy
Chief complaint
8. 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.
-26 - Professional Component
Flat bones
Provider Identification Number (PIN)
Medicaid
9. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
encounter form
Unspecified (hypertension)
The Patient Care Partnership (Patient's Bill of Rights)
Medically needy
10. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.
Patient Confidentiality
encounter form
The Patient Care Partnership (Patient's Bill of Rights)
Frontal Bone
11. 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
Liability insurance
Compliance Regulations
Paper Claim
Frontal Bone
12. This is not specified as benign or malignant in the diagnosis or medical record.
Pre-determination
Rejected claim
Unspecified (hypertension)
Section 3 Index to External Causes of Injury (E codes)
13. 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
Fee-for-Service
Occipital Bone
Health Maintenance Organization (HMO)
There are three layers to the skin
14. Benign growth extending from the surface of the mucous membrane
Polyp
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Qualified diagnosis
Occipital Bone
15. anterior to the temporal bones.
Capitated Rates
Sphenoid Bones
Mutually Exclusive Edits
Abuse
16. 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 -
The Current Procedural Terminology (CPT)
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Indemnity Insurance
lunula
17. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.
Birthday rule
Liability insurance
Rib Cage
Pre-certification
18. This is the inventory of the constitutional symptoms regarding the various body systems.
Colles
Point-of-Service plan (POS)
Review of Systems (ROS)
Medical necessity
19. 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.
Sub classification
Medicaid
Physician
Pathologic
20. 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
Pre-paid Health Plan
phalanges (phalanx.s)
Subcategories
There are two types of sweat glands
21. 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
Capitated Rates
Exclusions and Limitations
ulna
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
22. 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
Carcinoma (Ca) in situ
Evaluation and Management Review
-26 - Professional Component
23. Numbers 1-7 - attach directly to the sternum in the front of the body.
-51 - Multiple Procedures
true ribs
Salter-Harris
Point-of-Service plan (POS)
24. Deficient in pigment (melanin)
Albino
axial skeleton
upper appendicular skeleton
Lacrimal bones
25. forms the roof of the nasal cavity.
Ethmoid Bone
Mandible
appendicular skeleton .
No ROM
26. Is a managed care plan that gives beneficiaries the option whom to see for services. If the beneficiary goes to see a physician within the network - s/he will receive benefits similar to an HMO. But if the beneficiary chooses to see a physician from
Coordination of Benefits (COB)
Point-of-Service plan (POS)
appendicular skeleton .
bullet (a
27. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
Accept assignment
Impetigo
Impacted
Sesamoid bones
28. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Personal Insurance
Radius
Fee Schedule
Accept assignment
29. 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.
Subcategories
Flat bones
-99 - Multiple Modifiers
Non-covered benefit
30. Mild or controlled hypertension and no damage to the vascular system or organs.
Full ROM
Abuse
Benign (hypertension)
Secondary malignancy
31. Law passed by the federal government to prosecute cases of Medicaid fraud.
Employer Liability
Zygoma
Civil Monetary Penalties Law (CMPL)
Keratin
32. Unlike the RBRVS - the RVP has no geographic adjustment factor or individual RVU component to calculate. However - for each category of procedures - a separate conversion factor must be developed....
MEDICARE Part B
Malignant
Dirty claim
The St. Anthony Relative Value for Physicians (RVP)
33. Medicare Managed Care Plans (Formerly Medicare Plus (+) Choice Plan) was created to offer a number of healthcare services in addition to those available under Part A and Part B. The CMS contracts with managed care plans or provider service organizati
Performing Provider Identification Number (PPIN)
MEDICARE Part C
The Current Procedural Terminology (CPT)
axial skeleton
34. is defined as one who has not received any medical services within the last three years.
Rib Cage
Dirty claim
New Patient
Long bones
35. Pre-determined set of benefits covered under one set annual fee.
Lipocyte
Pre-paid Health Plan
Complicated
stand-alone codes
36. 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.
Rejected claim
Coordination of Benefits (COB)
Category III Codes CPT
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
37. The cuticle at the lower part of the nail and this is sometimes referred to as the
eponychium
Medicare
Category II Codes CPT
Unauthorized benefit
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
Ulcermembranes
Zygoma
Undetermined
Unlisted Procedures Procedures
39. A pregnant woman who has had at least one previous pregnancy.
Multigravida
essential modifiers
The St. Anthony Relative Value for Physicians (RVP)
Alopecia
40. Lower portion of the pelvic bone
Past - family and social history (PFSH)
axial skeleton
Commercial Carriers
Ischium
41. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.
Limited ROM
Performing Provider Identification Number (PPIN)
New Patient
Macule
42. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
Category I Codes CPT
sebaceous(oil) glands and the suddoriferous (sweat) glands
Abuse
Long bones
43. 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 -
Coinsurance
essential modifiers
Section 3 Index to External Causes of Injury (E codes)
Accident
44. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
No ROM
Fee-for-Service
Explanation of Benefits (EOB)
Wheal
45. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
Coinsurance
Gender rule
Malignant
Established patient
46. Knowingly and intentionally deceiving or misrepresenting information that may result in unauthorized benefits is known as fraud.. Common forms of fraud are billing for services not furnished - unbundling - and misrepresenting diagnosis to justify pay
A plus sign (+)
Unlisted Procedures Procedures
Mandible
Fraud
47. Produce secretions that allow the body to be moisturized or cooled.
sebaceous(oil) glands and the suddoriferous (sweat) glands
Frontal Bone
Indemnity Insurance
Flat bones
48. Is the federal government's health insurance program created by the Social Security Act of 1965 titled 'Health Insurance for the Aged and Disabled'. It is administered by the Centers for Medicare and Medicaid Services (CMS) - formerly known as Health
Unauthorized benefit
Limited ROM
Medicare
Two triangular symbols (a
49. Absence of hair from areas where it normally grows
-26 - Professional Component
Social Security Number
Alopecia
Nodule
50. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Mutually Exclusive Edits
MEDICARE Part A
Pre-paid Health Plan