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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. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Established patient
Chief complaint
Impetigo
Group Insurance
2. 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)
co-payment
Coordination of Benefits (COB)
Evaluation and Management Review
true ribs
3. Federal law that prohibits submitting a fraudulent claim or making a false statement or representation in connection with a claim. It also protects and rewards persons involved in whistle-blower cases.
true ribs
False Claims Act (FCA)
Non-covered benefit
Sections
4. Structural protein found in the skin and connective tissue
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Collagen
Vesicle
Ulcermembranes
5. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
Uncertain behavior
The Good Samaritan Act
Complicated
Uncertain behavior
6. 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.
Group practice
Keratin
Sections
Colles
7. To report a circumstance in which the physician returns to the operating room to address a complication stemming from the initial procedure - modifier -78 is attached to the subsequent procedure code.
Point-of-Service plan (POS)
Category I Codes CPT
Chapters
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
8. 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
Past - family and social history (PFSH)
-90 - Reference (Outside) Laboratory
Mutually Exclusive Edits
Alphabetic Index (Volume 2)
9. 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.
MEDICARE Part C
Limited ROM
Spinal/Vertebral Column
Category II Codes CPT
10. 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-determination
HCPCS Level I codes
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
11. 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
Compression fracture
stand-alone codes
Ischium
Fee-for-Service
12. Created the Health Care Fraud and Abuse Control Program enacted to check for fraud and abuse in the Medicare and Medicaid programs - and private payers.
Fee-for-Service
HCPCS Level II codes (National Codes)
Outpatient
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
13. 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
Reasons for Documentation
Explanation of Benefits (EOB)
Medicaid
Melanin
14. 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 -
The Universal Claim Form
Indemnity Insurance
Frontal Bone
Remittance Advice
15. Are small - rounded bones that resemble a sesame seed. They are found near joints and increase the efficiency of muscles near a joint. An example of sesamoid bone is the knee cap.
Sesamoid bones
Consultation
Electronic Claim
Categories
16. major skin pigment
Evaluation and Management Review
Categories
Melanin
Maxilla
17. 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
Coding
Compression fracture
Group Insurance
There are two types of sweat glands
18. Is the federal government's health insurance program created by the Social Security Act of 1965 titled 'Health Insurance for the Aged and Disabled'. It is administered by the Centers for Medicare and Medicaid Services (CMS) - formerly known as Health
Medicare
The Universal Claim Form
Salter-Harris
Group Insurance
19. Are conditions - situations - and services not covered by the insurance carrier.
False ribs
Preferred Provider Organization (PPO)
Collagen
Exclusions and Limitations
20. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
Radius
The Universal Claim Form
Greenstick
Deductible
21. Developed by the CMS to promote national correct coding methodologies and to control improper coding that leads to inappropriate payment of Part B health insurance claims.
National Correct Coding Initiative (NCCI)
Multigravida
ulna
Employee Liability
22. Produce secretions that allow the body to be moisturized or cooled.
nonessential modifiers
Liability insurance
Multigravida
sebaceous(oil) glands and the suddoriferous (sweat) glands
23. Are codes formulated thru the joint efforts of the CMS - the Health Insurance Association of America - and the Blue Cross and Blue Shield Association. Level II contains five position alpha-numeric codes for physician and non-physician services not fo
HCPCS Level II codes (National Codes)
Hairline
-51 - Multiple Procedures
Fiscal Intermediary
24. 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.
Civil Monetary Penalties Law (CMPL)
Category I Codes CPT
-26 - Professional Component
Pelvis
25. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Inferior nasal conchae
Unique Provider Identification Number (UPIN)
Employer Identification Number (EIN)
Uncertain behavior
26. 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
Explanation of Benefits (EOB)
Group practice
Clearinghouse
Lacrimal bones
27. This is not specified as benign or malignant in the diagnosis or medical record.
Disability insurance
Unspecified (hypertension)
ulna
Employer Identification Number (EIN)
28. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
Vesicle
Flat bones
Fraud
ligaments
29. 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.
nonessential modifiers
Chief complaint
Hairline
Performing Provider Identification Number (PPIN)
30. .. lower jaw bone.
Limited ROM
Mandible
Collagen
Unlisted Procedures Procedures
31. Law passed by the federal government to prosecute cases of Medicaid fraud.
Health Maintenance Organization (HMO)
premium
Civil Monetary Penalties Law (CMPL)
Dirty claim
32. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body
Preferred Provider Organization (PPO)
The Current Procedural Terminology (CPT)
Maxilla
Secondary malignancy
33. 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:
Modifiers
Hypertension Table
Short bones
Personal Insurance
34. 'Errors and omissions insurance' is protection against loss of monies caused by failure through error or unintentional omission on the part of the individual or service submitting the insurance claim. Some physicians' contract with a billing service
Alphabetic Index (Volume 2)
Employee Liability
Evaluation and Management Review
Salter-Harris
35. are composed of a group of three-digit categories representing a group of conditions or related conditions; they are divided into categories. e.g. . - Disorders of Thyroid Gland (240 - 246).
Civil Monetary Penalties Law (CMPL)
Unspecified (hypertension)
Sections
Employer Liability
36. 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..
Mutually Exclusive Edits
Primary malignancy
Musculoskeletal System
premium
37. 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
Alphabetic Index (Volume 2)
premium
Liability insurance
Accident
38. 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
Unspecified (hypertension)
Carpals
Sebaceous glands
Compression fracture
39. 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
Explanation of Benefits (EOB)
Maxilla
Greenstick
MEDICARE Part D
40. Are the main division in the ICD-9-CM; they are divided into sections. e.g.. - 3. Endocrine - Nutritional and Metabolic Diseases - and Immunity Disorders (240-279).
Chapters
Unspecified (hypertension)
Coordination of Benefits (COB)
Nonparticipating physician
41. The CPT manual is composed of eight sections. Each section begins with guidelines that provide specific coding rules for that section. Guidelines at the beginning of the section are applicable to all codes in the section - while notes that pertain t
Evaluation and Management Review
Add-on codes
Lacrimal bones
CPT SECTIONS.
42. 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.
nonessential modifiers
-99 - Multiple Modifiers
Collagen
Medicaid
43. 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.
Fee-for-Service
Carpals
Disability insurance
There are three layers to the skin
44. This is a set of information the physician gathers from the patient regarding the following:
lunula
Mutually Exclusive Edits
Greenstick
History
45. the bone is broken and the ends are driven into each other.
Ethmoid Bone
History of present illness (HPI)
Impacted
Macule
46. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.
Limited ROM
Mandible
Categories
-99 - Multiple Modifiers
47. 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'.
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Pre-authorization
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Suicide Attempt
48. Poisoning cannot be determined whether intentional or accidental.
Undetermined
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
-51 - Multiple Procedures
Review of Systems (ROS)
49. Small collection of clear fluid;blister
MEDICARE Part A
Medicaid
Sebaceous glands
Vesicle
50. Are composed of three-digit codes representing a single disease or condition.
Category III Codes CPT
Long bones
Surgical Package
Categories