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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. make up part of the roof of the mouth
Medically needy
Palatine bones
Employer Liability
The Patient Care Partnership (Patient's Bill of Rights)
2. 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.
Clearinghouse
Retention of Medical Records
Carpals
Limited ROM
3. Represent services and procedures widely used by many health care professionals in clinical practice in multiple locations and have been approved by the FDA.
A plus sign (+)
Ulcermembranes
Category I Codes CPT
Ischium
4. 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
Column 1/Column 2 (previously called Comprehensive/Component) Edits
MEDICAID COVERAGE
Chief complaint
Capitated Rates
5. Make up part of the interior of the nose.
Humerus
Inferior nasal conchae
MEDICARE Part B
Electronic Claim
6. make up part of the roof of the mouth
appendicular skeleton .
Suicide Attempt
Parietal Bones
Palatine bones
7. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.
Coinsurance
Participating physician
Category III Codes CPT
Frontal Bone
8. is a federal program administered by state governments to provide medical assistance to the needy. Each state sets its own guidelines for eligibility and services - therefore benefits and coverage may vary widely from state to state.
The St. Anthony Relative Value for Physicians (RVP)
Medicaid
False ribs
Location Methods
9. Is the upper arm bone.
Humerus
Employee Liability
Preferred Provider Organization (PPO)
Birthday rule
10. the bone is crushed and or shattered.
Long bones
Comminuted fracture
MEDICARE Part D
ligaments
11. The lower anterior part of the bone
Pubic bone
Wheal
Palatine bones
MEDICARE Part C
12. Considered experimental - newly approved - or seldom used may not be listed in the CPT manual. These codes can be coded as unlisted procedures. They are located at the end of the subsections or subheadings. When an unlisted procedure code is reported
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Eligibility
Unlisted Procedures Procedures
HCPCS Level I codes
13. - To pay for medical services and items that Medicare does not cover and Medicare's coinsurance and deductibles - beneficiaries may purchase a supplemental insurance. Medigap is a private insurance designed to help pay for those amounts that are typ
Gangrene
Medigap (Medicare Supplemental Insurance)
Provider Identification Number (PIN)
Categorically needy -MEDICAID
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
Fiscal Intermediary
Chief complaint (CC)
Malignant
15. Poisoning cannot be determined whether intentional or accidental.
Group Provider Number
Pubic bone
Undetermined
Ulcermembranes
16. The Usual - Customary - and Reasonable: The UCR method is used mostly in reference to fee-for-service reimbursement. To arrive at a payment amount for a claim - the carrier compares: The physician's most frequent charge for a given service (the usual
Chief complaint (CC)
No ROM
Fee Schedule
Impacted
17. Describes the services billed and includes a breakdown of how the payment is determined
The Good Samaritan Act
Explanation of Benefits (EOB)
Preferred Provider plan
History of present illness (HPI)
18. Poisoning was due to: Accidental overdose; Wrong substance taken; Accidents in use of drugs and biologicals; External causes of poisonings classifiable to 980-989 Therapeutic Use: instances when a correct substance properly taken is the cause of adve
Accident
Multigravida
Malignant
Musculoskeletal System
19. Deficient in pigment (melanin)
Benign (hypertension)
Albino
Limited ROM
Ulcermembranes
20. Are a group of independently licensed local companies - usually nonprofit that contracts with physicians and other health entities to provide services to their insured companies and individuals. Most BC/BS plans offer HMO's - PPO's and POS plans. Blu
Chapters
Blue Cross/Blue Shield Plans
Compliance Regulations
Health Insurance Portability and Accountability Act (HIPAA)
21. 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
Paper Claim
New patient
Relative Value Payment Schedules Method
Sebaceous glands
22. 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.
Nonparticipating physician
Advance Beneficiary Notice
Physician
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
23. 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
Health Care Financing Administration Common Procedure Coding System
Multigravida
Employee Liability
Salter-Harris
24. 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.
Unique Provider Identification Number (UPIN)
Hairline
Lipocyte
Medical Records
25. Poisoning cannot be determined whether intentional or accidental.
circle with a line through it)
Undetermined
The Integumentary System
Assault
26. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.
Limited ROM
Medicaid
False Claims Act (FCA)
Ulcermembranes
27. Is an electronic or paper-based report of payment sent by the payer to the provider.
Preferred Provider Organization (PPO)
Malignant
Remittance Advice
Occipital Bone
28. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.
MEDICARE Part D
Zygoma
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Limited ROM
29. 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)...
Pre-paid Health Plan
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Preferred Provider plan
30.
Rib Cage
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Macule
Sub classification
31. requires investigation and needs further clarification.
-32 - Mandated Services
Outpatient
The Good Samaritan Act
Rejected claim
32. Is a regionally managed healthcare program for active duty and retired members of the armed forces - their families - and survivors. It is a service benefit program and contains no premium. TRICARE is the new title for the CHAMPUS program (Civilian H
Peer Review Organization (PRO)
TRICARE
Birthday rule
co-payment
33. A fat cell
Ethmoid Bone
Limited ROM
Lipocyte
Medically needy
34. A fracture of the epiphyseal plate in children.
Impetigo
Salter-Harris
Rib Cage
New Patient
35. The epidermis - the dermis - and the subcutaneous layer. The epidermis is a thin - cellular membrane layer that contains keratin. The dermis is a dense - fibrous - connective tissue that contains collagen. The subcutaneous layer is a thicker and fatt
There are three layers to the skin
MEDICARE Part B
Hypertension Table
Category II Codes CPT
36. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Gangrene
Keratin
Unspecified nature
Macule
37. The moon like white area at the base of the nail.
Fee Schedule
No ROM
lunula
Medical necessity
38. 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.
Vesicle
Established Patient
Fee-for-Service
-90 - Reference (Outside) Laboratory
39. 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
Neoplasm Table
-32 - Mandated Services
Disability insurance
Group Provider Number
40. Upper jaw bone
TRICARE PLANS
Maxilla
Invalid claim
co-payment
41. open sore on the skin or mucous
Clearinghouse
Add-on codes
Ulcermembranes
Abuse
42. 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
Evaluation and Management Review
Clearinghouse
Mutually Exclusive Edits
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
43. 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
Add-on codes
Chief complaint
Dirty claim
44. 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.
Participating physician
-26 - Professional Component
Advance Beneficiary Notice
Category II Codes CPT
45. 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
Vomer
Group Insurance
Gangrene
Two triangular symbols (a
46. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.
Undetermined
Participating physician
Subcategories
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
47. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Maxilla
Rib Cage
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
48. uncertain whether benign or malignant; borderline malignancy
eponychium
Category III Codes CPT
Uncertain behavior
Salter-Harris
49. uncertain whether benign or malignant; borderline malignancy
Macule
Uncertain behavior
Pubic bone
Eligibility
50. Is the lateral lower arm bone (in line with the thumb).
Wheal
sebaceous(oil) glands and the suddoriferous (sweat) glands
Radius
Health Insurance Portability and Accountability Act (HIPAA)