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Test your basic knowledge |
Medical Billing And Coding Vocab
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Subject
:
medical-transcription
Instructions:
Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can
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. 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
Neoplasm Table
Blue Cross/Blue Shield Plans
Salter-Harris
TRICARE PLANS
2. paired bones at the corner of each eye that cradle the tear ducts.
-51 - Multiple Procedures
Remittance Advice
sprain
Lacrimal bones
3. Is a cost-sharing requirement for the insured to pay at the time of service. This amount is usually a specific dollar amount (e.g.. $15 - $20 - $25)
History of present illness (HPI)
co-payment
Retention of Medical Records
essential modifiers
4. 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.
Vesicle
Medical Records
Mutually Exclusive Edits
Workers Compensation
5. Absence of hair from areas where it normally grows
Alopecia
Pathologic
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Employer Identification Number (EIN)
6. 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.
Rib Cage
Nodule
itemized statement
Employer Liability
7. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
TRICARE PLANS
Surgical Package
Point-of-Service plan (POS)
Long bones
8. Are temporary codes for emerging technology - services and procedures. If a Category III code is available - it is reported instead of a Category I unlisted code.
Provider Identification Number (PIN)
Frontal Bone
Retention of Medical Records
Category III Codes CPT
9. The musculoskeletal system includes the bones - muscles - and joints The musculoskeletal system acts as a framework for the organs - protects many of those organs - and also provides the organism the ability to move..
Fee-for-Service
Musculoskeletal System
Nodule
nonessential modifiers
10. 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
Health Maintenance Organization (HMO)
HCPCS Level I codes
Spinal/Vertebral Column
MEDICAID COVERAGE
11. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients
HCPCS Level I codes
Relative Value Payment Schedules Method
Accept assignment
Health practitioner
12. Are the finger bones. Each finger has three phalanges - except for the thumb. The three phalanges are the proximal - middle and a distal phalanx. The thumb has a proximal and distal.
Humerus
Chapters
phalanges (phalanx.s)
Remittance Advice
13. uncertain whether benign or malignant; borderline malignancy
Radius
Uncertain behavior
Malignant
Birthday rule
14. This is the inventory of the constitutional symptoms regarding the various body systems.
Medicare
Review of Systems (ROS)
Employer Identification Number (EIN)
Explanation of Benefits (EOB)
15. 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
Benign
stand-alone codes
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Point-of-Service plan (POS)
16. 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
The Good Samaritan Act
Past - family and social history (PFSH)
Point-of-Service plan (POS)
upper appendicular skeleton
17.
Workers Compensation
Section 3 Index to External Causes of Injury (E codes)
HCPCS Level II codes (National Codes)
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
18. Are conditions - situations - and services not covered by the insurance carrier.
Exclusions and Limitations
Surgical Package
Short bones
Unauthorized benefit
19. Medicaid is the payer of last resort. If the patient has Medicare and Medicaid - Medicaid usually pays for the Medicare Part B deductible - coinsurance - and monthly premium amounts. Some of the services covered by Medicaid include the following: Inp
Long bones
Frontal Bone
MEDICAID COVERAGE
National Correct Coding Initiative (NCCI)
20. Is the upper arm bone.
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Benign (hypertension)
Participating physician
Humerus
21. This is attached to the code of the E/M service provided to a patient during the postoperative period to indicate that that service is not part of the postoperative care which is usually part of a package of services of the surgery performed. Major s
Hairline
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Multigravida
co-payment
22. 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
ulna
Preferred Provider plan
The Integumentary System
Secondary malignancy
23. forms the two lower sides of the cranium.
Medical Records
Deductible
Location Methods
Temporal Bone
24. Any fracture occurring spontaneously as a result of disease.
Sections
Sesamoid bones
Pathologic
Fiscal Intermediary
25. 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
Fee Schedule
-51 - Multiple Procedures
False ribs
Medical Records
26. Under this schedule - a procedure's relative value is the sum total of three elements: Work: represents the amount of time - intensity of effort - and medical skill required of the physician. Overhead: practice costs related to the performing of the
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27. The moon like white area at the base of the nail.
New Patient
lunula
Invalid claim
axial skeleton
28. most synarthroses are immovable joints held together by fibrous tissue.
Lacrimal bones
Unlisted Procedures Procedures
Albino
No ROM
29. 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 -
Indemnity Insurance
Group Insurance
nonessential modifiers
Malignant
30. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
Comminuted fracture
Health Maintenance Organization (HMO)
Collagen
Flat bones
31. solid - round or oval elevated lesion more than 1 cm in diameter
HCPCS Level II codes (National Codes)
Remittance Advice
Albino
Nodule
32. Provide a four-digit code (one digit after the decimal point) which is more specific than category code (3-digit) in terms of cause - site - or manifestation of the condition. This must be used if available. From subcategory - specificity moves to an
Subcategories
Invalid claim
New Patient
False Claims Act (FCA)
33. 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
Vesicle
Accept assignment
co-payment
Birthday rule
34. Poisoning cannot be determined whether intentional or accidental.
Undetermined
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Limited ROM
Personal Insurance
35. is referred to as Supplementary Medical Insurance (SMI). This coverage is a supplement to Part A - which covers medical expenses - clinical laboratory services - home health care - outpatient hospital treatment - blood - and ambulatory surgical serv
Alopecia
Impetigo
appendicular skeleton .
MEDICARE Part B
36. The bone is broken and pierces an internal organ
Collagen
Deductible
Categories
Complicated
37. 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.
Advance Beneficiary Notice
Chapters
Comminuted fracture
Spinal/Vertebral Column
38. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Invalid claim
A plus sign (+)
Unlisted Procedures Procedures
Accept assignment
39. Cheekbone
Medicaid
Liability insurance
Colles
Zygoma
40. Is a fee that is charged for each procedure or service performed by the physician. This fee is obtained from a fee schedule - which is a list of charges or allowance that have accepted for specific medical services. The system in which fee schedules
-90 - Reference (Outside) Laboratory
Advance Beneficiary Notice
Fee-for-Service
Review of Systems (ROS)
41. 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.
Inpatient
Commercial Carriers
Carpals
Social Security Number
42. 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.
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Secondary malignancy
Add-on codes
Short bones
43. 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
TRICARE PLANS
Pre-certification
Gangrene
44. Is made up of the shoulder - collar - pelvic and arms and legs
-32 - Mandated Services
Employer Identification Number (EIN)
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
appendicular skeleton .
45. Number assigned to the physician by Medicare program.
Lipocyte
Nonparticipating physician
Alopecia
Unique Provider Identification Number (UPIN)
46. poisoning was inflicted by another person with intent to kill or injure
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Polyp
Location Methods
Assault
47. Represents a change in the code description since the last edition. The change may be minor or significant and it could be an addition - deletion or revision.
Sections
Impetigo
Categories
triangle (a
48. 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)
Collagen
Vesicle
TRICARE PLANS
49. Further classified as to primary - secondary - or carcinoma in situ.
Occipital Bone
Palatine bones
Malignant
Medicare
50. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Two triangular symbols (a
Capitated Rates
Unspecified nature
Occipital Bone