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. This modifier is used when the same procedure is performed on a mirror-image part of the body..
Polyp
Group practice
The St. Anthony Relative Value for Physicians (RVP)
-50 - Bilateral Procedure
2. 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
Dirty claim
Capitated Rates
Lacrimal bones
Liability insurance
3. consists of 17 chapters based on either body system or cause or type of disease. The codes range from 001-999.
Employer Liability
New patient
Chief complaint
Tabular List (Volume 1)...
4. numbers 8-10 - are attached to the sternum by cartilage
Evaluation and Management Review
Blue Cross/Blue Shield Plans
Chief complaint
False ribs
5. most synarthroses are immovable joints held together by fibrous tissue.
Remittance Advice
No ROM
-99 - Multiple Modifiers
Established Patient
6. Groove or crack like sore
The Universal Claim Form
Hairline
Fissure
Clean claim
7. 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.
Sesamoid bones
itemized statement
Medical Records
Sub classification
8. 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.
Medicaid
MEDICARE Part D
Compression fracture
MEDICARE Part B
9. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.
Health Maintenance Organization (HMO)
-90 - Reference (Outside) Laboratory
encounter form
Review of Systems (ROS)
10. 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
Paper Claim
Clean claim
-90 - Reference (Outside) Laboratory
Neoplasm Table
11. Is a group of two or more physicians and non-physician practitioners legally organized in a partnership - professional corporation - foundation - not-for-profit corporation - faculty practice plan - or similar association.
Modifiers
Ulcermembranes
Categories
Group practice
12. Is the cost of insurance coverage paid annually - semi-annually or monthly to keep a policy in effect.
premium
Advance Beneficiary Notice
Medigap (Medicare Supplemental Insurance)
Invalid claim
13. 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'.
ligaments
sprain
National Correct Coding Initiative (NCCI)
Pre-authorization
14. contains errors or omissions. Usually - these claims do not pass front-end edits. They are either processed manually for resolving problems - or rejected for payment.
Vomer
Social Security Number
Dirty claim
Medicare Claim Status
15. The E&M section includes codes that pertain to the nature of the physicians' work. The codes depend on type of service - patient status - and place where service was rendered. The E&M section is divided into broad categories such as office visits - h
Sub classification
Point-of-Service plan (POS)
Evaluation and Management Review
Colles
16. 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
TRICARE PLANS
bullet (a
Health practitioner
stand-alone codes
17. Is the lateral lower arm bone (in line with the thumb).
Compression fracture
Radius
triangle (a
Category II Codes CPT
18. Forms the sides of the cranium
Polyp
Health practitioner
Uncertain behavior
Parietal Bones
19. paired bones at the corner of each eye that cradle the tear ducts.
Lacrimal bones
Categorically needy -MEDICAID
Electronic Claim
Health practitioner
20. numbers 8-10 - are attached to the sternum by cartilage
Gangrene
Mutually Exclusive Edits
Pre-authorization
False ribs
21. Is a state-required insurance plan - the coverage of which provides benefits to employees and their dependents for work related injury - illness or death. Each state has an established minimum number of employees required before this law comes into e
Workers Compensation
Exclusions and Limitations
Ischium
Occipital Bone
22. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
A plus sign (+)
Coding
Polyp
Benign (hypertension)
23. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
Physician
Gender rule
False ribs
Medically needy
24. is one who has not received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years.
Comminuted fracture
Pre-authorization
New patient
Pelvis
25. 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
Advance Beneficiary Notice
Point-of-Service plan (POS)
nonessential modifiers
Sections
26. Number assigned to the physician by Medicare program.
Unique Provider Identification Number (UPIN)
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
The Current Procedural Terminology (CPT)
Section 3 Index to External Causes of Injury (E codes)
27. 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
Evaluation and Management Review
ligaments
Keratin
Commercial Carriers
28. Represent services and procedures widely used by many health care professionals in clinical practice in multiple locations and have been approved by the FDA.
New patient
Category I Codes CPT
The St. Anthony Relative Value for Physicians (RVP)
Undetermined
29. Is the lateral lower arm bone (in line with the thumb).
Indemnity Insurance
Radius
Vesicle
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
30. A fracture of the epiphyseal plate in children.
Occipital Bone
Full ROM
Salter-Harris
Employer Liability
31. Are wrist bones. There are 2 rows of four bones in the wrist. The metacarpals are the five radiating bones in the fingers. These are the bones in the palm of the hand.
Sub classification
Group Insurance
-32 - Mandated Services
Carpals
32. 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.
co-payment
The Patient Care Partnership (Patient's Bill of Rights)
Tabular List (Volume 1)...
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
33. death of tissue associated with loss of blood supply
triangle (a
Nonparticipating physician
Parietal Bones
Gangrene
34. The lower anterior part of the bone
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Collagen
Pubic bone
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
35. Small collection of clear fluid;blister
The Current Procedural Terminology (CPT)
Preferred Provider plan
Liability insurance
Vesicle
36. The reason the patient came to see the physician.
Abuse
History
Carcinoma (Ca) in situ
Chief complaint (CC)
37. forms the roof of the nasal cavity.
Explanation of Benefits (EOB)
Evaluation and Management Review
Ethmoid Bone
Nodule
38. 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
Group practice
Medical Records
MEDICARE Part B
Medical necessity
39. 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
Categorically needy -MEDICAID
Explanation of Benefits (EOB)
Unauthorized benefit
Past - family and social history (PFSH)
40. Is the lower medial arm bone.
Rib Cage
Frontal Bone
Coding
ulna
41. Is when two insurance companies work together to coordinate payment of the benefits.
Ethmoid Bone
Coordination of Benefits (COB)
Categories
Tabular List (Volume 1)...
42. 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 -
Sub classification
Non-covered benefit
Indemnity Insurance
Sections
43. Pre-determined set of benefits covered under one set annual fee.
Pre-paid Health Plan
Consultation
Deductible
Impacted
44. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
Social Security Number
circle with a line through it)
Macule
Flat bones
45. provides a five-digit code which gives the highest specificity of description to a condition. Use of it is mandatory if it is available. A code not reported to the full number of digits required is invalid. e.g. 240.01 Toxic diffuse goiter with thyr
MEDICARE Part A
Qualified diagnosis
Neoplasm Table
Sub classification
46. 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
Benign
Group practice
Subcategories
Location Methods
47. A pregnant woman who has had at least one previous pregnancy.
MEDICARE Part B
Multigravida
Gender rule
Gangrene
48. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.
Fraud
Secondary malignancy
bullet (a
Participating physician
49. HCPCS Reference Manual The CMS assigns a standard unique identifier known as the National Provider Identifier (NPI) The CMS also developed a two-part coding system called the Healthcare Common Procedure Coding System ( HCPCS ) which is a collection o
Impetigo
Health Care Financing Administration Common Procedure Coding System
TRICARE PLANS
Carcinoma (Ca) in situ
50. 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
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Category III Codes CPT
itemized statement
Preferred Provider Organization (PPO)