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Test your basic knowledge |
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.
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. Further classified as to primary - secondary - or carcinoma in situ.
Malignant
The Universal Claim Form
Medical Records
Neoplasm Table
2. Is when two insurance companies work together to coordinate payment of the benefits.
Flat bones
Compression fracture
Coordination of Benefits (COB)
Qualified diagnosis
3. Deficient in pigment (melanin)
Albino
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Assault
The Patient Care Partnership (Patient's Bill of Rights)
4. 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.
Health Insurance Portability and Accountability Act (HIPAA)
Established Patient
MEDICARE Part A
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
5. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Unspecified nature
Hypertension Table
Sub classification
Nonparticipating physician
6. is defined as reimbursement for income lost as a result of a temporary or permanent illness or injury. When patients are treated for disability diagnoses and other medical problems - separate patient records must be maintained. Disability insurance
sebaceous(oil) glands and the suddoriferous (sweat) glands
Health Maintenance Organization (HMO)
Disability insurance
Pre-authorization
7. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Flat bones
Mutually Exclusive Edits
Medical necessity
Unauthorized benefit
8. 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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9. 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
Compliance Regulations
Workers Compensation
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
National Correct Coding Initiative (NCCI)
10. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Health Care Financing Administration Common Procedure Coding System
Employer Identification Number (EIN)
Paper Claim
MEDICARE Part D
11. This is an alternative to paper claims submitted to the third-party payer directly by the physician or through a clearinghouse. Electronic claims are usually paid faster than paper claims and most electronic claims software have self-editing features
Unique Provider Identification Number (UPIN)
axial skeleton
circle with a line through it)
Electronic Claim
12. Forms the sides of the cranium
Parietal Bones
History
Undetermined
The Good Samaritan Act
13. Consists of the skull - rib cage - and spine
History of present illness (HPI)
History
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
axial skeleton
14. 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
Spinal/Vertebral Column
circle with a line through it)
Medigap (Medicare Supplemental Insurance)
Relative Value Payment Schedules Method
15. Is a statement of the patient's account history - showing dates of service - detailed charges - payments (i.e. deductibles and co-pays) - the date the insurance claim was submitted - applicable adjustments and account balance.
itemized statement
Social Security Number
Established Patient
Full ROM
16. Indicates add-on codes
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
A plus sign (+)
Workers Compensation
Pelvis
17. 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
Nonparticipating physician
MEDICARE Part C
History
Compliance Regulations
18. 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
Employer Liability
State License Number
Capitated Rates
Location Methods
19. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.
Health Maintenance Organization (HMO)
Pelvis
Categorically needy -MEDICAID
encounter form
20. A pregnant woman who has had at least one previous pregnancy.
Malignant
Greenstick
Multigravida
Impetigo
21. 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
ligaments
Medical Records
bullet (a
Suicide Attempt
22. A minor fracture appears as a thin line on x-ray and may not extend completely through the bone.
Full ROM
Rib Cage
Hairline
Pre-authorization
23. .. lower jaw bone.
Evaluation and Management Review
Mandible
Sections
Gangrene
24. 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
The Current Procedural Terminology (CPT)
Commercial Carriers
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Ethmoid Bone
25. The reason the patient came to see the physician.
Non-covered benefit
Rejected claim
Keratin
Chief complaint (CC)
26. 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 -
essential modifiers
Participating physician
Mutually Exclusive Edits
Chief complaint
27. Contain the full description of the procedure for the code indented codes: these are codes listed under associated stand-alone codes. To complete the description for indented codes - one must refer to the portion of the stand alone code description b
TRICARE PLANS
stand-alone codes
Gender rule
Malignant
28. 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
Mutually Exclusive Edits
Employer Liability
Impetigo
Occipital Bone
29. found in the Index under the main term 'Hypertension' - and it contains a list of conditions that are due to or associated with hypertension. The table classifies the conditions as:
Health Maintenance Organization (HMO)
Hypertension Table
Frontal Bone
Neoplasm Table
30. 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
Group Insurance
upper appendicular skeleton
Chapters
31. A fat cell
Lipocyte
Alopecia
Location Methods
TRICARE PLANS
32. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
Fissure
Medically needy
essential modifiers
Participating physician
33. The physician must obtain this number in order to practice within a state.
Compliance Regulations
Gangrene
Provider Identification Number (PIN)
State License Number
34. Pre-determined set of benefits covered under one set annual fee.
Pre-paid Health Plan
Medicare Claim Status
Relative Value Payment Schedules Method
lunula
35. death of tissue associated with loss of blood supply
Gangrene
Lipocyte
Spinal/Vertebral Column
Deductible
36. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called
Employer Liability
Keratin
Colles
Primary malignancy
37. 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.'
-99 - Multiple Modifiers
Medical necessity
Pelvis
Unauthorized benefit
38. 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
Mutually Exclusive Edits
-51 - Multiple Procedures
Capitated Rates
Unique Provider Identification Number (UPIN)
39. 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.
Keratin
co-payment
Pre-determination
Non-covered benefit
40. the bone is crushed and or shattered.
ulna
Inferior nasal conchae
Group Provider Number
Comminuted fracture
41. 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.
triangle (a
Fee Schedule
Fissure
Colles
42. Further classified as to primary - secondary - or carcinoma in situ.
Gangrene
Impetigo
Frontal Bone
Malignant
43. 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.
circle with a line through it)
Carpals
False ribs
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
44. 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
Birthday rule
nonessential modifiers
Medicare
Alphabetic Index (Volume 2)
45. 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.
Alopecia
Deductible
Fiscal Intermediary
-26 - Professional Component
46. Eccrine sweat glands are the most common and the apocrine sweat glands that secrete an odorless sweat.
There are two types of sweat glands
Greenstick
State License Number
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
47. 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.
Inpatient
Compression fracture
Carcinoma (Ca) in situ
Ethmoid Bone
48. make up part of the roof of the mouth
Dirty claim
Palatine bones
nonessential modifiers
sebaceous(oil) glands and the suddoriferous (sweat) glands
49. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
No ROM
Sphenoid Bones
Long bones
Paper Claim
50. is basically the same as HMO in the sense that the health care provider enters into contract with the MCOs to render services to the beneficiaries. However - PPO's charge a higher premium than HMO's in exchange for more flexibility and more options
Chapters
Preferred Provider Organization (PPO)
Complicated
Temporal Bone