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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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study here
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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. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).
Primary malignancy
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Malignant
Participating physician
2. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
The Patient Care Partnership (Patient's Bill of Rights)
Chief complaint
Ulcermembranes
Fiscal Intermediary
3. Are located in the dermal layer of the skin over the entire body - except for the palms of the hands and soles of the feet. The sebaceous glands secrete an oily substance called sebum. Sebum contains lipids that help lubricate the skin and minimize w
Sebaceous glands
Clean claim
Keratin
Coding
4. solid - round or oval elevated lesion more than 1 cm in diameter
Nodule
Capitated Rates
ligaments
Gender rule
5. This modifier is used when the same procedure is performed on a mirror-image part of the body..
Column 1/Column 2 (previously called Comprehensive/Component) Edits
-50 - Bilateral Procedure
Humerus
Category II Codes CPT
6. It is important that every patient seen by the physician has comprehensive legible documentation about the patient's illness - treatment and plans for the following reasons Avoidance of denied or delayed payments by insurance carriers investigating t
Pre-determination
Reasons for Documentation
Review of Systems (ROS)
Collagen
7. Structural protein found in the skin and connective tissue
CPT SECTIONS.
Macule
New patient
Collagen
8. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
Inpatient
Malignant
Indemnity Insurance
Two triangular symbols (a
9. 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
lunula
Performing Provider Identification Number (PPIN)
The Current Procedural Terminology (CPT)
Employer Liability
10. anterior to the temporal bones.
HCPCS Level I codes
Sphenoid Bones
Coordination of Benefits (COB)
Fiscal Intermediary
11. Are supplemental codes used for performance measurements. Although these codes are intended to facilitate data collection about the quality of care - their use is optional. Category II codes are published twice a year: January 1st and July 1st.
Relative Value Payment Schedules Method
Nodule
Malignant
Category II Codes CPT
12. consists of 17 chapters based on either body system or cause or type of disease. The codes range from 001-999.
Tabular List (Volume 1)...
Reasons for Documentation
-32 - Mandated Services
Group Provider Number
13. Is the upper arm bone.
Lipocyte
Limited ROM
Paper Claim
Humerus
14. 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.
Medically needy
Section 3 Index to External Causes of Injury (E codes)
No ROM
New Patient
15. 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
Temporal Bone
National Correct Coding Initiative (NCCI)
Outpatient
Reasons for Documentation
16. is a traumatic injury to a joint involving the soft tissue.
sprain
Long bones
Musculoskeletal System
Birthday rule
17. 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.
-51 - Multiple Procedures
Workers Compensation
Group practice
Performing Provider Identification Number (PPIN)
18. 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.
Compliance Regulations
Unlisted Procedures Procedures
-51 - Multiple Procedures
Dirty claim
19. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).
eponychium
Fee Schedule
Add-on codes
Column 1/Column 2 (previously called Comprehensive/Component) Edits
20. 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 -
MEDICARE Part C
-32 - Mandated Services
Indemnity Insurance
Ischium
21. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Employer Identification Number (EIN)
Sesamoid bones
Benign (hypertension)
Keratin
22. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
Health practitioner
-32 - Mandated Services
Advance Beneficiary Notice
Fiscal Intermediary
23. Represents a new procedure or service code added since the previous edition of the manual.
bullet (a
False ribs
Birthday rule
Coding
24. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
Health Insurance Portability and Accountability Act (HIPAA)
Comminuted fracture
MEDICARE Part A
Malignant
25. Indicates add-on codes
A plus sign (+)
lunula
Humerus
HCPCS Level I codes
26. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
False ribs
Carpals
Carcinoma (Ca) in situ
itemized statement
27. Physicians are legally responsible for their own conduct and any actions of their employees (their designee) performed within the context of their employment. This is referred to as 'vicarious liability -' also known as 'respondent superior -' which
Employer Liability
Hypertension Table
CPT SECTIONS.
Coordination of Benefits (COB)
28. Numbers 1-7 - attach directly to the sternum in the front of the body.
Abuse
true ribs
The Integumentary System
Malignant
29. represents Exemption from the use of modifier -51
Preferred Provider plan
Compression fracture
National Correct Coding Initiative (NCCI)
circle with a line through it)
30. forms the two lower sides of the cranium.
History of present illness (HPI)
Temporal Bone
Pre-determination
Vesicle
31. 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
Consultation
stand-alone codes
Pathologic
Complicated
32. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Coding
Fiscal Intermediary
A plus sign (+)
33. The lower anterior part of the bone
Pubic bone
Primary malignancy
Malignant
Humerus
34. the bone is crushed and or shattered.
Comminuted fracture
Performing Provider Identification Number (PPIN)
-51 - Multiple Procedures
Pre-determination
35. 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.
The Universal Claim Form
Abuse
Reasons for Documentation
Medical Records
36. A physician has a separate PPIN for each group office/clinic in which he or she practices. In the Medicare program - in addition to a group number - each member of a group is issued an 8-character performing provider identification number.
Evaluation and Management Review
The Integumentary System
Health Maintenance Organization (HMO)
Performing Provider Identification Number (PPIN)
37. 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.
-99 - Multiple Modifiers
Social Security Number
Parietal Bones
Group practice
38. 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.
Non-covered benefit
Suicide Attempt
Patient Confidentiality
Hypertension Table
39. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called
Point-of-Service plan (POS)
False Claims Act (FCA)
Evaluation and Management Review
Keratin
40. Represent services and procedures widely used by many health care professionals in clinical practice in multiple locations and have been approved by the FDA.
Pelvis
Category I Codes CPT
Category III Codes CPT
Pre-authorization
41. requires investigation and needs further clarification.
Vesicle
ligaments
Rejected claim
The Current Procedural Terminology (CPT)
42. the bone is broken and the ends are driven into each other.
Patient Confidentiality
Pre-determination
Impacted
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
43. Prescription Drugs The Medicare Prescription Drug - Improvement - and Modernization Act enacted in December 2003 and began implementation in January 2006 where Medicare beneficiaries can enroll in the Medicare prescription drug plan. The beneficiari
Carpals
MEDICARE Part D
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Compliance Regulations
44. 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
Primary malignancy
encounter form
Group Insurance
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
45. 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
Deductible
The Universal Claim Form
co-payment
Sesamoid bones
46. 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.
Fee-for-Service
Primary malignancy
-51 - Multiple Procedures
Non-covered benefit
47. Includes - but is not limited to - physician assistant - certified nurse-midwife - qualified psychologist - nurse practitioner - clinical social worker - physical therapist - occupational therapist - respiratory therapist - certified registered nurse
Health practitioner
Pre-paid Health Plan
Group Provider Number
Medically needy
48. 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.
Group Provider Number
New patient
Dirty claim
False ribs
49. 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
MEDICARE Part A
There are two types of sweat glands
Keratin
50. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Suicide Attempt
Unique Provider Identification Number (UPIN)
Secondary malignancy
Coding