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. Make up part of the interior of the nose.
Inferior nasal conchae
There are three layers to the skin
-26 - Professional Component
Paper Claim
2. 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.
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Pre-determination
Preferred Provider plan
Undetermined
3. Is a managed care benefits plan that provides a wide range of medical services to individuals that have been enrolled into the program. It is generally the least costly but at the same time also the most restrictive. This plan uses a gatekeeper physi
Inferior nasal conchae
False ribs
Health Maintenance Organization (HMO)
Accept assignment
4. 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
Invalid claim
Wheal
ligaments
Medicare
5. Retention of medical records is governed by state and local laws and may vary from state-to-state. Most physicians are required to retain records indefinitely; deceased patient records should be kept for at least five (5) years.
Retention of Medical Records
Comminuted fracture
Fee Schedule
Chief complaint
6. 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.
Collagen
Non-covered benefit
The Patient Care Partnership (Patient's Bill of Rights)
MEDICAID COVERAGE
7. A fracture of the epiphyseal plate in children.
Impacted
Long bones
true ribs
Salter-Harris
8. A fat cell
TRICARE
Inferior nasal conchae
sebaceous(oil) glands and the suddoriferous (sweat) glands
Lipocyte
9. Are composed of three-digit codes representing a single disease or condition.
encounter form
Fissure
Categories
Established Patient
10. anterior to the temporal bones.
Fissure
Capitated Rates
Deductible
Sphenoid Bones
11. This is a set of information the physician gathers from the patient regarding the following:
Macule
Category I Codes CPT
History
Invalid claim
12. 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 -
Preferred Provider Organization (PPO)
Fissure
upper appendicular skeleton
essential modifiers
13. 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:
MEDICARE Part B
Hypertension Table
HCPCS Level II codes (National Codes)
encounter form
14. 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
CPT SECTIONS.
Inferior nasal conchae
CPT SECTIONS.
15. This modifier is used when: more than one procedure is performed during the same surgical episode; one code does not describe all of the procedures performed; and the secondary procedure is not minor or incidental to the major procedure. The followin
-51 - Multiple Procedures
Preferred Provider plan
The Good Samaritan Act
Evaluation and Management Review
16. 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
Group Provider Number
Past - family and social history (PFSH)
Unspecified nature
Clean claim
17. 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
History
-32 - Mandated Services
phalanges (phalanx.s)
TRICARE PLANS
18. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
Fiscal Intermediary
Wheal
-26 - Professional Component
Impetigo
19. 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.
Disability insurance
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Preferred Provider plan
Medicaid
20. forms the roof of the nasal cavity.
Fraud
Limited ROM
Ethmoid Bone
There are two types of sweat glands
21. includes the shoulder girdle which is made up of the scapula - clavicle and upper extremities. The scapula - or shoulder blades are flat bones that help support the arms. The clavicle - or collarbone - is curved horizontal bones that attach to the u
Uncertain behavior
No ROM
upper appendicular skeleton
Birthday rule
22. 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:
Hypertension Table
Advance Beneficiary Notice
Maxilla
Fee Schedule
23. anterior to the temporal bones.
Nonparticipating physician
Sphenoid Bones
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Sections
24. The lower anterior part of the bone
Established patient
Unauthorized benefit
Fee-for-Service
Pubic bone
25. 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
Colles
Accept assignment
Location Methods
Salter-Harris
26. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
History of present illness (HPI)
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Mutually Exclusive Edits
Chapters
27. Structural protein found in the skin and connective tissue
There are two types of sweat glands
State License Number
There are two types of sweat glands
Collagen
28. male of household is primary payer
ulna
Non-covered benefit
Clean claim
Gender rule
29. 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
Full ROM
Rejected claim
Remittance Advice
Relative Value Payment Schedules Method
30. Is an entity that receives transmissions of claims from physicians' offices - separates the claims by carriers and performs software edits on each claim to check for errors. Once this process is complete - the claim is then sent to the proper insuran
Participating physician
Ethmoid Bone
Personal Insurance
Clearinghouse
31. Retention of medical records is governed by state and local laws and may vary from state-to-state. Most physicians are required to retain records indefinitely; deceased patient records should be kept for at least five (5) years.
Collagen
Retention of Medical Records
Fee-for-Service
Carpals
32. 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.
Clean claim
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Unspecified nature
Medical necessity
33. 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'.
Surgical Package
Pre-authorization
Limited ROM
Group practice
34. Any fracture occurring spontaneously as a result of disease.
Fee Schedule
Pre-certification
Exclusions and Limitations
Pathologic
35. Was created to provide medical benefits to spouses and children of veterans with total - permanent service related disabilities or for surviving spouses and children of a veteran who died as a result of service-related disability. It is a service ben
False ribs
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Sections
Primary malignancy
36. Numbers 1-7 - attach directly to the sternum in the front of the body.
Abuse
true ribs
Keratin
Group Insurance
37. Consists of the skull - rib cage - and spine
Parietal Bones
axial skeleton
Medicaid
Pelvis
38. Deficient in pigment (melanin)
Keratin
Albino
phalanges (phalanx.s)
Chapters
39. Upper jaw bone
The Good Samaritan Act
Unspecified (hypertension)
Maxilla
New Patient
40. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
New Patient
HCPCS Level I codes
Mutually Exclusive Edits
Column 1/Column 2 (previously called Comprehensive/Component) Edits
41. 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.
Preferred Provider plan
History of present illness (HPI)
Long bones
Non-covered benefit
42. This modifier is used to indicate that the procedure was done by an outside laboratory and not by the reporting facility or clinic.
eponychium
-90 - Reference (Outside) Laboratory
Rib Cage
New Patient
43. Noninvasive - non-spreading - nonmalignant
Benign
Vomer
Wheal
Greenstick
44. Any fracture occurring spontaneously as a result of disease.
There are two types of sweat glands
Lipocyte
There are two types of sweat glands
Pathologic
45. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Unspecified (hypertension)
Sesamoid bones
Carcinoma (Ca) in situ
46. 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
Paper Claim
Hairline
essential modifiers
encounter form
47. 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.
Modifiers
Retention of Medical Records
National Correct Coding Initiative (NCCI)
Nodule
48. Forms the anterior part of the skull and the forehead
Unspecified (hypertension)
Fee Schedule
Chapters
Frontal Bone
49. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).
Subcategories
The Good Samaritan Act
Keratin
Column 1/Column 2 (previously called Comprehensive/Component) Edits
50. Various terms are used to describe the state of submitted forms. The following are some of the terms that are typically used by insurance carriers.
Category II Codes CPT
-50 - Bilateral Procedure
Fiscal Intermediary
Medicare Claim Status