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. Poisoning cannot be determined whether intentional or accidental.
Secondary malignancy
Undetermined
National Correct Coding Initiative (NCCI)
State License Number
2. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
Wheal
Primary malignancy
Ulcermembranes
Complicated
3. 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
Inferior nasal conchae
Health Insurance Portability and Accountability Act (HIPAA)
sprain
Medicare
4. 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.
Preferred Provider plan
Consultation
Fee-for-Service
appendicular skeleton .
5. Represents a new procedure or service code added since the previous edition of the manual.
Performing Provider Identification Number (PPIN)
Medically needy
New Patient
bullet (a
6. 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
Sphenoid Bones
Occipital Bone
Occipital Bone
Spinal/Vertebral Column
7. Provide the means by which the reporting physician can indicate that a service or procedure that has been performed has been altered by some specific circumstance but not changed in its definition or code.
Exclusions and Limitations
Remittance Advice
Two triangular symbols (a
Modifiers
8. The reason the patient came to see the physician.
Ulcermembranes
HCPCS Level I codes
Multigravida
Chief complaint (CC)
9. The main term in the index may by followed by terms within parenthesis.
Limited ROM
Flat bones
Alphabetic Index (Volume 2)
Full ROM
10. Upper jaw bone
Medically needy
Maxilla
New patient
Surgical Package
11. 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.
The Current Procedural Terminology (CPT)
History
Non-covered benefit
Compliance Regulations
12. Is a document provided to a Medicare beneficiary by a provider prior to service being rendered letting the beneficiary know of his/her responsibility to pay if Medicare denies the claim.
Paper Claim
Advance Beneficiary Notice
Carpals
Suicide Attempt
13. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.
The Current Procedural Terminology (CPT)
Greenstick
The Integumentary System
Employer Liability
14. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
Flat bones
There are three layers to the skin
The Good Samaritan Act
Advance Beneficiary Notice
15. The fractured area of bone collapses on itself.
The Universal Claim Form
Compression fracture
False ribs
History
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 -
Ethmoid Bone
MEDICAID COVERAGE
Add-on codes
Indemnity Insurance
17. forms the roof of the nasal cavity.
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Category I Codes CPT
The Good Samaritan Act
Ethmoid Bone
18. 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.
ligaments
Chief complaint (CC)
Pathologic
Carpals
19. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Outpatient
Malignant
Point-of-Service plan (POS)
Mutually Exclusive Edits
20. This modifier is used to report a procedure or service that has more than one Modifier but the third-party payer does not allow the addition of multiple modifiers to the code. Modifier -99 is attached to the procedure code and the multiple Modifiers
-99 - Multiple Modifiers
Employee Liability
appendicular skeleton .
Sections
21. Is the upper arm bone.
-50 - Bilateral Procedure
Pre-authorization
Compliance Regulations
Humerus
22. The CPT manual is composed of eight sections. Each section begins with guidelines that provide specific coding rules for that section. Guidelines at the beginning of the section are applicable to all codes in the section - while notes that pertain t
Uncertain behavior
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
CPT SECTIONS.
Civil Monetary Penalties Law (CMPL)
23. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
Hypertension Table
Mutually Exclusive Edits
Rib Cage
-51 - Multiple Procedures
24. 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.
Rejected claim
Clean claim
Liability insurance
-50 - Bilateral Procedure
25. Lower portion of the pelvic bone
Ischium
Salter-Harris
Malignant
Peer Review Organization (PRO)
26. 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
Unlisted Procedures Procedures
False ribs
Sub classification
Palatine bones
27. Is defined as a doctor of medicine or osteopathy - dental medicine - dental surgery - podiatric medicine - optometry - or chiropractic medicine legally authorized to practice by the state in which he/she performs.
Invalid claim
Nonparticipating physician
Physician
Humerus
28. This is the traditional method used by providers for submission of charges to insurance companies. The most commonly used form is the CMS-1500. Few plans still accept the physician's encounter form or superbill and Medicare will only accept claims on
The Current Procedural Terminology (CPT)
Unspecified nature
Paper Claim
Clean claim
29. Is made up of the shoulder - collar - pelvic and arms and legs
Nodule
appendicular skeleton .
Unique Provider Identification Number (UPIN)
bullet (a
30. Families - pregnant women - and children ;Aid to Families with Dependent Children (AFDC)-related groups ;Non-AFDC pregnant women and children;Aged and disabled persons ;Supplemental Security Income (SSI)-related groups ;Qualified Medicare Beneficiari
Carcinoma (Ca) in situ
Categorically needy -MEDICAID
Peer Review Organization (PRO)
There are three layers to the skin
31. anterior to the temporal bones.
The Integumentary System
Inpatient
Sphenoid Bones
Mutually Exclusive Edits
32. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
Eligibility
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
CPT SECTIONS.
Wheal
33. 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....
encounter form
Coinsurance
Review of Systems (ROS)
The St. Anthony Relative Value for Physicians (RVP)
34. Represent changes in the text or definition between the triangles.
sprain
Personal Insurance
Neoplasm Table
Two triangular symbols (a
35. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
Deductible
Review of Systems (ROS)
Paper Claim
Lipocyte
36. Benign growth extending from the surface of the mucous membrane
Modifiers
Polyp
Indemnity Insurance
New patient
37. 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.
Impacted
Undetermined
Non-covered benefit
Section 3 Index to External Causes of Injury (E codes)
38. Contains complete - necessary information - but is incorrect or illogical in some way.
Invalid claim
Alopecia
eponychium
Pre-paid Health Plan
39. 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
Established patient
Group Insurance
Pre-authorization
Flat bones
40. Upper jaw bone
-50 - Bilateral Procedure
Maxilla
Review of Systems (ROS)
TRICARE PLANS
41. Are supplementary classification codes used to describe the reason or external cause of injury - poisoning and other adverse effects. These codes can be found in both Volumes I and II. E codes are used to classify environmental events - circumstances
ligaments
Pelvis
Deductible
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
42. This modifier is used to indicate that the procedure or service provided during the postoperative period was not associated with the initial procedure. Payment for the full fee of the subsequent procedure is requested and a new global period starts.
Indemnity Insurance
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Nodule
Sphenoid Bones
43. Is when two insurance companies work together to coordinate payment of the benefits.
Point-of-Service plan (POS)
Unlisted Procedures Procedures
Coordination of Benefits (COB)
Non-covered benefit
44. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Polyp
Rejected claim
Coding
False ribs
45. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
Location Methods
State License Number
The Universal Claim Form
Wheal
46. 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.
Accident
Medical Records
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
appendicular skeleton .
47. - is a procedure or service provided without proper authorization or was not covered by a current authorization. The claim is denied and the provider cannot bill the patient for the charges.
Unauthorized benefit
Sphenoid Bones
-50 - Bilateral Procedure
Eligibility
48. Are composed of three-digit codes representing a single disease or condition.
Categories
co-payment
Advance Beneficiary Notice
itemized statement
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
Rejected claim
Health Care Financing Administration Common Procedure Coding System
Abuse
axial skeleton
50. This is the inventory of the constitutional symptoms regarding the various body systems.
Review of Systems (ROS)
Rib Cage
MEDICARE Part C
-32 - Mandated Services