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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
.
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. This is the inventory of the constitutional symptoms regarding the various body systems.
Musculoskeletal System
Parietal Bones
Contracted Rates with MCOs
Review of Systems (ROS)
2. This is a set of information the physician gathers from the patient regarding the following:
Full ROM
MEDICARE Part A
Consultation
History
3. These parenthetic terms are called because their presence or absence does not have an effect on the selection of the code listed for the main term.
The Current Procedural Terminology (CPT)
Health practitioner
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
nonessential modifiers
4. 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
Fiscal Intermediary
Radius
Sebaceous glands
Health Maintenance Organization (HMO)
5. is defined as one who has not received any medical services within the last three years.
New Patient
premium
Benign (hypertension)
Compliance Regulations
6. Discolored - flat lesion (freckles - tattoo marks)
Complicated
Macule
Chapters
There are three layers to the skin
7. Superior and widest bone
Pelvis
Remittance Advice
Disability insurance
Comminuted fracture
8. The poisoning was self-inflicted.
Pre-certification
Suicide Attempt
Compression fracture
Palatine bones
9. 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.
Inferior nasal conchae
Hairline
MEDICARE Part C
itemized statement
10. 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
National Correct Coding Initiative (NCCI)
CPT SECTIONS.
Birthday rule
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
11. This is defined as incidents or practices - not usually considered fraudulent - that are inconsistent with the accepted medical business or fiscal practices in the industry. Examples of abuse are submitting a claim for a service or procedure performe
Abuse
encounter form
Modifiers
-32 - Mandated Services
12. The poisoning was self-inflicted.
Suicide Attempt
Group Insurance
Past - family and social history (PFSH)
Medicare
13. .. lower jaw bone.
Mandible
Unspecified nature
Deductible
Melanin
14. make up part of the roof of the mouth
Unspecified nature
Explanation of Benefits (EOB)
Pelvis
Palatine bones
15. Groove or crack like sore
Short bones
Fissure
Musculoskeletal System
The Current Procedural Terminology (CPT)
16. 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.
Indemnity Insurance
Modifiers
Melanin
Ethmoid Bone
17. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
Medicaid
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Ulcermembranes
Full ROM
18. male of household is primary payer
Non-covered benefit
Gender rule
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Ischium
19. Pre-determined set of benefits covered under one set annual fee.
Melanin
Pre-paid Health Plan
Musculoskeletal System
Salter-Harris
20. 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.
Birthday rule
Retention of Medical Records
Health practitioner
Unique Provider Identification Number (UPIN)
21. 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.
The Patient Care Partnership (Patient's Bill of Rights)
Peer Review Organization (PRO)
Performing Provider Identification Number (PPIN)
Group practice
22. This number is used instead of the individual physician's number for the performing provider who is a member of a group practice that submits claims to insurance companies under the group name.
Group Provider Number
MEDICARE Part B
Assault
Dirty claim
23. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.
Hairline
Remittance Advice
encounter form
Group practice
24. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called
Keratin
Nonparticipating physician
Palatine bones
Disability insurance
25. 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
Gangrene
Pubic bone
CPT SECTIONS.
Clearinghouse
26. 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
Pre-certification
Employer Identification Number (EIN)
Unlisted Procedures Procedures
27. This is used to indicate that the service provided was required by a third-party payer - governmental - legislative - or regulatory body. This does not include second opinion requested by a patient - family member - or another physician.
-32 - Mandated Services
Categories
Pre-certification
Medicare Claim Status
28. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.
The Good Samaritan Act
Evaluation and Management Review
Peer Review Organization (PRO)
Group Insurance
29. Number assigned to the physician by Medicare program.
Unique Provider Identification Number (UPIN)
eponychium
stand-alone codes
Eligibility
30. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
Retention of Medical Records
Vesicle
Vomer
Long bones
31. Is one who has received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years....
Established patient
lunula
Clearinghouse
Social Security Number
32. Absence of hair from areas where it normally grows
Participating physician
Multigravida
Macule
Alopecia
33. 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
Eligibility
eponychium
Fee Schedule
MEDICARE Part D
34. 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
Complicated
Established Patient
MEDICAID COVERAGE
Multigravida
35. The reason the patient came to see the physician.
Employer Identification Number (EIN)
Performing Provider Identification Number (PPIN)
Outpatient
Chief complaint (CC)
36. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Neoplasm Table
Sesamoid bones
Chief complaint
Employer Identification Number (EIN)
37. Lower portion of the pelvic bone
Ischium
Compliance Regulations
Add-on codes
Review of Systems (ROS)
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.
appendicular skeleton .
Established Patient
Gender rule
upper appendicular skeleton
39. 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
Clearinghouse
Carcinoma (Ca) in situ
essential modifiers
Spinal/Vertebral Column
40. anterior to the temporal bones.
Flat bones
Categories
Sphenoid Bones
Colles
41. Law passed by the federal government to prosecute cases of Medicaid fraud.
Civil Monetary Penalties Law (CMPL)
Employee Liability
Ethmoid Bone
MEDICARE Part C
42. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Chief complaint
False Claims Act (FCA)
Eligibility
Limited ROM
43. uncertain whether benign or malignant; borderline malignancy
Fraud
Uncertain behavior
Sphenoid Bones
Fissure
44. Upper jaw bone
Maxilla
Pre-paid Health Plan
Reasons for Documentation
Hairline
45. the bone is broken and the ends are driven into each other.
Impacted
Gangrene
Abuse
lunula
46. This modifier is used to explain that the procedure or service done during a postoperative period was planned at the time of the original procedure. This is also used if a therapeutic procedure is performed because of the findings from a diagnostic p
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Medigap (Medicare Supplemental Insurance)
Frontal Bone
Alopecia
47. 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.
Surgical Package
Carpals
appendicular skeleton .
Vomer
48. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
Flat bones
Impetigo
Mutually Exclusive Edits
ulna
49. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
Humerus
Medigap (Medicare Supplemental Insurance)
Benign (hypertension)
Fiscal Intermediary
50. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.
Impacted
Coding
Pre-certification
-99 - Multiple Modifiers