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 is the index for the E codes.It classifies - in alphabetical order - environmental events and other conditions as the cause of injury and other adverse effects.
Section 3 Index to External Causes of Injury (E codes)
The St. Anthony Relative Value for Physicians (RVP)
Alopecia
Liability insurance
2. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Accept assignment
History
Chief complaint
3. - To pay for medical services and items that Medicare does not cover and Medicare's coinsurance and deductibles - beneficiaries may purchase a supplemental insurance. Medigap is a private insurance designed to help pay for those amounts that are typ
Spinal/Vertebral Column
Zygoma
Medical Records
Medigap (Medicare Supplemental Insurance)
4. 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
Birthday rule
Short bones
Unspecified nature
5. Make up part of the interior of the nose.
Social Security Number
Inferior nasal conchae
Physician
Pelvis
6. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Employer Identification Number (EIN)
Keratin
Parietal Bones
Social Security Number
7. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Commercial Carriers
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Comminuted fracture
Chief complaint
8. The reason the patient came to see the physician.
Chief complaint (CC)
Pathologic
Hypertension Table
A plus sign (+)
9. Any fracture occurring spontaneously as a result of disease.
Evaluation and Management Review
Pathologic
Uncertain behavior
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
10. is a traumatic injury to a joint involving the soft tissue.
TRICARE PLANS
sprain
Civil Monetary Penalties Law (CMPL)
Health practitioner
11. 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
Compression fracture
Pelvis
Accident
The Good Samaritan Act
12. Is defined as someone who has received medical services with in the last 3 years from the physician or another physician of the same specialty who belongs to the same group practice.
Participating physician
Established Patient
premium
Employer Liability
13. 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
itemized statement
Liability insurance
Advance Beneficiary Notice
Zygoma
14. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.
Palatine bones
Wheal
Participating physician
Limited ROM
15. 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
Frontal Bone
Group Insurance
MEDICARE Part A
Provider Identification Number (PIN)
16. Contains complete - necessary information - but is incorrect or illogical in some way.
Mandible
Employer Identification Number (EIN)
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Invalid claim
17. the bone is crushed and or shattered.
Compliance Regulations
MEDICAID COVERAGE
Comminuted fracture
triangle (a
18. 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.
Add-on codes
Hairline
The Integumentary System
Electronic Claim
19. paired bones at the corner of each eye that cradle the tear ducts.
Remittance Advice
Established patient
Group Insurance
Lacrimal bones
20. Is the lateral lower arm bone (in line with the thumb).
Radius
Fissure
Social Security Number
CPT SECTIONS.
21. Is when two insurance companies work together to coordinate payment of the benefits.
No ROM
Limited ROM
Coordination of Benefits (COB)
Fraud
22. Is to determine the patient's benefits and the maximum dollar amount that the insurance company will pay. Often the first step of the insurance verification process - it is completed prior to the first visit.
Polyp
HCPCS Level II codes (National Codes)
Modifiers
Pre-determination
23. 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
Pubic bone
Point-of-Service plan (POS)
Explanation of Benefits (EOB)
Sub classification
24. Eccrine sweat glands are the most common and the apocrine sweat glands that secrete an odorless sweat.
Remittance Advice
Invalid claim
Employer Liability
There are two types of sweat glands
25. 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
MEDICARE Part C
Salter-Harris
Complicated
Primary malignancy
26. 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
-50 - Bilateral Procedure
Outpatient
Polyp
Liability insurance
27. Codes from the CPT codebook are used to report services and procedures by physicians. It is published and updated annually by the American Medical Association (AMA) with a new one coming out each November and becoming effective on January 1st of the
TRICARE
The Current Procedural Terminology (CPT)
Deductible
Blue Cross/Blue Shield Plans
28. They are for profit organizations that operate in the private sector selling different health insurance benefits plans to groups or individuals. Most commercial plans have predefined patient yearly deductibles and coinsurance generally based on 80/2
Temporal Bone
Two triangular symbols (a
phalanges (phalanx.s)
Commercial Carriers
29. solid - round or oval elevated lesion more than 1 cm in diameter
Nodule
Unspecified nature
Relative Value Payment Schedules Method
Ulcermembranes
30. Are conditions - situations - and services not covered by the insurance carrier.
Fiscal Intermediary
Suicide Attempt
Exclusions and Limitations
-90 - Reference (Outside) Laboratory
31. - To pay for medical services and items that Medicare does not cover and Medicare's coinsurance and deductibles - beneficiaries may purchase a supplemental insurance. Medigap is a private insurance designed to help pay for those amounts that are typ
Medigap (Medicare Supplemental Insurance)
Fee Schedule
Pubic bone
Advance Beneficiary Notice
32. The bone is broken and pierces an internal organ
Evaluation and Management Review
There are two types of sweat glands
Complicated
Palatine bones
33. This involves the use of relative value scales which assign a relative weight to individual services according to the basis for the scale. Services that are more difficult - time consuming - or resource intensive to perform typically have higher rela
New patient
Relative Value Payment Schedules Method
There are three layers to the skin
Surgical Package
34. Are a group of independently licensed local companies - usually nonprofit that contracts with physicians and other health entities to provide services to their insured companies and individuals. Most BC/BS plans offer HMO's - PPO's and POS plans. Blu
Inferior nasal conchae
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Rejected claim
Blue Cross/Blue Shield Plans
35. 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
Accept assignment
A plus sign (+)
National Correct Coding Initiative (NCCI)
Fraud
36. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the
Primary malignancy
Humerus
-90 - Reference (Outside) Laboratory
MEDICARE Part A
37. Noninvasive - non-spreading - nonmalignant
Benign
History of present illness (HPI)
Parietal Bones
MEDICARE Part A
38. This is used to indicate that the service provided was required by a third-party payer - governmental - legislative - or regulatory body. This does not include second opinion requested by a patient - family member - or another physician.
-32 - Mandated Services
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Long bones
No ROM
39. Is an electronic or paper-based report of payment sent by the payer to the provider.
triangle (a
premium
Remittance Advice
Hypertension Table
40. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
Outpatient
The Good Samaritan Act
The St. Anthony Relative Value for Physicians (RVP)
Employee Liability
41. 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
Pre-authorization
Unspecified (hypertension)
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Point-of-Service plan (POS)
42. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
Undetermined
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Carcinoma (Ca) in situ
Health practitioner
43. 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
Occipital Bone
Preferred Provider plan
The Universal Claim Form
Social Security Number
44. 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
MEDICARE Part D
HCPCS Level II codes (National Codes)
Chapters
The Universal Claim Form
45. Groove or crack like sore
Electronic Claim
Personal Insurance
State License Number
Fissure
46. are small with irregular shapes. They are found in the wrist and ankle.
Medical Records
Category II Codes CPT
Short bones
Chief complaint (CC)
47. death of tissue associated with loss of blood supply
sprain
Gangrene
encounter form
itemized statement
48. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.
encounter form
Patient Confidentiality
MEDICAID COVERAGE
Keratin
49. Law passed by the federal government to prosecute cases of Medicaid fraud.
Collagen
Sesamoid bones
Civil Monetary Penalties Law (CMPL)
Nonparticipating physician
50. 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
Category I Codes CPT
Exclusions and Limitations
Tabular List (Volume 1)...
The Integumentary System