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Test your basic knowledge |
Medical Billing And Coding Vocab
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Study First
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. 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.
-50 - Bilateral Procedure
Accept assignment
Carpals
Coding
2. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
Carcinoma (Ca) in situ
MEDICARE Part A
Location Methods
Maxilla
3. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the
The Integumentary System
MEDICARE Part A
Point-of-Service plan (POS)
Fissure
4. A chronological account of the development of the complaint from the first sign or symptom that the patient experienced to the present
Fee-for-Service
Add-on codes
History of present illness (HPI)
False Claims Act (FCA)
5. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.
Pelvis
Pre-certification
History
MEDICARE Part A
6. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
No ROM
Health Insurance Portability and Accountability Act (HIPAA)
Keratin
Dirty claim
7. Noninvasive - non-spreading - nonmalignant
New patient
Accept assignment
Health practitioner
Benign
8. 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.
itemized statement
Modifiers
Established patient
Carcinoma (Ca) in situ
9. The E&M section includes codes that pertain to the nature of the physicians' work. The codes depend on type of service - patient status - and place where service was rendered. The E&M section is divided into broad categories such as office visits - h
HCPCS Level I codes
Evaluation and Management Review
Nonparticipating physician
Medical Records
10. Is when two insurance companies work together to coordinate payment of the benefits.
Hairline
Long bones
Coordination of Benefits (COB)
Deductible
11. Structural protein found in the skin and connective tissue
Medicare
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Collagen
Mutually Exclusive Edits
12. Represent services and procedures widely used by many health care professionals in clinical practice in multiple locations and have been approved by the FDA.
Fraud
Gender rule
Category I Codes CPT
Rib Cage
13. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.
Fee-for-Service
Birthday rule
Greenstick
Fiscal Intermediary
14. 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.
Medigap (Medicare Supplemental Insurance)
-26 - Professional Component
Clean claim
Commercial Carriers
15. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Ischium
-90 - Reference (Outside) Laboratory
Mutually Exclusive Edits
History
16. is one who has not received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years.
New patient
MEDICARE Part B
Humerus
Dirty claim
17. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
Wheal
Clean claim
The Good Samaritan Act
Remittance Advice
18. Is to determine the patient's benefits and the maximum dollar amount that the insurance company will pay. Often the first step of the insurance verification process - it is completed prior to the first visit.
There are three layers to the skin
Location Methods
Gangrene
Pre-determination
19. is a traumatic injury to a joint involving the soft tissue.
Rib Cage
sprain
Ethmoid Bone
Relative Value Payment Schedules Method
20. Consists of the skull - rib cage - and spine
eponychium
New Patient
axial skeleton
co-payment
21. 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
stand-alone codes
Nodule
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Carpals
22. The main term in the index may by followed by terms within parenthesis.
There are two types of sweat glands
Comminuted fracture
Impetigo
Alphabetic Index (Volume 2)
23. This is the inventory of the constitutional symptoms regarding the various body systems.
axial skeleton
Group Insurance
Review of Systems (ROS)
Accident
24. Describes the services billed and includes a breakdown of how the payment is determined
Review of Systems (ROS)
Capitated Rates
Explanation of Benefits (EOB)
Birthday rule
25. Is the lateral lower arm bone (in line with the thumb).
State License Number
Provider Identification Number (PIN)
Radius
Civil Monetary Penalties Law (CMPL)
26. 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.
Performing Provider Identification Number (PPIN)
Category II Codes CPT
Sections
Collagen
27. The physician must obtain this number in order to practice within a state.
State License Number
Consultation
Greenstick
Established patient
28. This is located in the Index under the main term 'Neoplasm' and is organized by anatomic site. Each site has six columns with six possible codes determined by whether the neoplasm is malignant - benign - of uncertain behavior - or of unspecified natu
False Claims Act (FCA)
Provider Identification Number (PIN)
Colles
Neoplasm Table
29. the bone is crushed and or shattered.
Established Patient
Pelvis
Employer Identification Number (EIN)
Comminuted fracture
30.
Category I Codes CPT
Blue Cross/Blue Shield Plans
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
-32 - Mandated Services
31. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
upper appendicular skeleton
Rib Cage
Hairline
Fiscal Intermediary
32. 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
Parietal Bones
Clearinghouse
There are three layers to the skin
Medicare Claim Status
33. 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.
Blue Cross/Blue Shield Plans
Long bones
Modifiers
Unique Provider Identification Number (UPIN)
34. The physician must obtain this number in order to practice within a state.
Radius
A plus sign (+)
Category II Codes CPT
State License Number
35. Unlike the RBRVS - the RVP has no geographic adjustment factor or individual RVU component to calculate. However - for each category of procedures - a separate conversion factor must be developed....
-99 - Multiple Modifiers
The St. Anthony Relative Value for Physicians (RVP)
Category III Codes CPT
Non-covered benefit
36. Lower portion of the pelvic bone
Evaluation and Management Review
Ischium
Fissure
Birthday rule
37. Eccrine sweat glands are the most common and the apocrine sweat glands that secrete an odorless sweat.
Medical necessity
Fee-for-Service
Mandible
There are two types of sweat glands
38. 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
Commercial Carriers
Group Provider Number
Blue Cross/Blue Shield Plans
Health Maintenance Organization (HMO)
39. 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:
Hypertension Table
Secondary malignancy
Musculoskeletal System
Reasons for Documentation
40. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Coding
Two triangular symbols (a
Workers Compensation
Rib Cage
41. 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.
Preferred Provider Organization (PPO)
Carcinoma (Ca) in situ
Retention of Medical Records
MEDICARE Part C
42. Cheekbone
Zygoma
Outpatient
Assault
Parietal Bones
43. Indicates add-on codes
Fee Schedule
A plus sign (+)
Malignant
Complicated
44. 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
A plus sign (+)
MEDICARE Part D
Health Maintenance Organization (HMO)
-26 - Professional Component
45. Benign growth extending from the surface of the mucous membrane
phalanges (phalanx.s)
Polyp
Indemnity Insurance
Hypertension Table
46. Is the lower medial arm bone.
ulna
Categorically needy -MEDICAID
Musculoskeletal System
Hairline
47. This modifier is used to indicate that the procedure or service provided during the postoperative period was not associated with the initial procedure. Payment for the full fee of the subsequent procedure is requested and a new global period starts.
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
MEDICARE Part C
Retention of Medical Records
48. 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
Carcinoma (Ca) in situ
Advance Beneficiary Notice
Retention of Medical Records
The Current Procedural Terminology (CPT)
49. Number assigned by the insurance company to a physician who renders services to patients.
Provider Identification Number (PIN)
Category II Codes CPT
The Current Procedural Terminology (CPT)
MEDICARE Part B
50. 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.
Colles
appendicular skeleton .
State License Number
Group practice