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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. solid - round or oval elevated lesion more than 1 cm in diameter
MEDICARE Part D
Maxilla
Nodule
sprain
2. The main term in the index may by followed by terms within parenthesis.
appendicular skeleton .
Alphabetic Index (Volume 2)
Category II Codes CPT
Palatine bones
3. - is a procedure or service provided without proper authorization or was not covered by a current authorization. The claim is denied and the provider cannot bill the patient for the charges.
Section 3 Index to External Causes of Injury (E codes)
Unauthorized benefit
Mandible
essential modifiers
4. 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.
Carpals
Established Patient
Fee Schedule
Capitated Rates
5. Noninvasive - non-spreading - nonmalignant
Malignant
Personal Insurance
Benign
Sections
6. An insurance plan issued to an individual. Premium rates are usually higher than group rates and service availability is lessened with this type of coverage.
Provider Identification Number (PIN)
Multigravida
Personal Insurance
Categorically needy -MEDICAID
7. 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.
Medicare
true ribs
-32 - Mandated Services
eponychium
8. male of household is primary payer
Fiscal Intermediary
Gender rule
Categorically needy -MEDICAID
Established patient
9. Represent changes in the text or definition between the triangles.
Two triangular symbols (a
Location Methods
bullet (a
Sphenoid Bones
10. Groove or crack like sore
Fissure
Coordination of Benefits (COB)
Electronic Claim
Consultation
11. 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.
Reasons for Documentation
Flat bones
False Claims Act (FCA)
Sphenoid Bones
12. This is not specified as benign or malignant in the diagnosis or medical record.
Fissure
Unspecified (hypertension)
Lipocyte
There are two types of sweat glands
13. 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:
Fissure
Hypertension Table
Salter-Harris
Medigap (Medicare Supplemental Insurance)
14. 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.
Workers Compensation
Unlisted Procedures Procedures
Inpatient
Frontal Bone
15. Is a percentage of the cost of covered services that a policyholder or a secondary insurance pays. A common payment percentage for coinsurance is 80/20 which indicates that 20% is the coinsurance for which the beneficiary or secondary insurance is re
Benign
Peer Review Organization (PRO)
Vomer
Coinsurance
16. 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
Consultation
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
There are three layers to the skin
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
17. Is made up of the shoulder - collar - pelvic and arms and legs
Medically needy
appendicular skeleton .
Clean claim
Suicide Attempt
18. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).
Pubic bone
Group Insurance
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Electronic Claim
19. Is defined as a doctor of medicine or osteopathy - dental medicine - dental surgery - podiatric medicine - optometry - or chiropractic medicine legally authorized to practice by the state in which he/she performs.
Pre-certification
Fissure
Physician
Ischium
20. Represent services and procedures widely used by many health care professionals in clinical practice in multiple locations and have been approved by the FDA.
Category I Codes CPT
stand-alone codes
Categorically needy -MEDICAID
Exclusions and Limitations
21. 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....
Lacrimal bones
Unlisted Procedures Procedures
Established patient
Birthday rule
22. Is a patient who receives treatment in any of the following settings: physician's office ;hospital clinic - emergency department - hospital same-day surgery unit - ambulatory surgical center ( patient is released within 23 hours) ;hospital admission
Rib Cage
Unauthorized benefit
Outpatient
No ROM
23. 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
Malignant
Non-covered benefit
Hypertension Table
There are three layers to the skin
24. 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
Chief complaint (CC)
Disability insurance
Pre-certification
Complicated
25. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called
Keratin
Assault
Review of Systems (ROS)
Coding
26. The reason the patient came to see the physician.
Sesamoid bones
Chief complaint (CC)
Location Methods
Employee Liability
27. 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
premium
Primary malignancy
Health practitioner
State License Number
28. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
Parietal Bones
Impetigo
Eligibility
Rib Cage
29. The lower anterior part of the bone
Reasons for Documentation
Pubic bone
Sebaceous glands
Retention of Medical Records
30. Produce secretions that allow the body to be moisturized or cooled.
Physician
Hairline
Malignant
sebaceous(oil) glands and the suddoriferous (sweat) glands
31. the bone is broken and the ends are driven into each other.
Musculoskeletal System
Medicare Claim Status
Impacted
itemized statement
32. 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
Fee Schedule
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Chapters
Retention of Medical Records
33. poisoning was inflicted by another person with intent to kill or injure
There are three layers to the skin
Keratin
Assault
Pre-authorization
34. 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
Benign (hypertension)
Clearinghouse
False ribs
Section 3 Index to External Causes of Injury (E codes)
35. Is a state-required insurance plan - the coverage of which provides benefits to employees and their dependents for work related injury - illness or death. Each state has an established minimum number of employees required before this law comes into e
Workers Compensation
Comminuted fracture
Category III Codes CPT
Health Maintenance Organization (HMO)
36. This modifier is used when the same procedure is performed on a mirror-image part of the body..
Mutually Exclusive Edits
-50 - Bilateral Procedure
Zygoma
Abuse
37. Physicians agree to provide services at a discount of their usual fee in return for a pool of existing patients.
Chief complaint (CC)
Contracted Rates with MCOs
sprain
Collagen
38. Consists of the skull - rib cage - and spine
sebaceous(oil) glands and the suddoriferous (sweat) glands
axial skeleton
-32 - Mandated Services
Sesamoid bones
39. 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
Unspecified nature
Assault
Neoplasm Table
Group Provider Number
40. Structural protein found in the skin and connective tissue
HCPCS Level II codes (National Codes)
co-payment
Consultation
Collagen
41. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
Qualified diagnosis
The Good Samaritan Act
Physician
Carcinoma (Ca) in situ
42. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the
Albino
MEDICARE Part A
-99 - Multiple Modifiers
Medically needy
43. A pregnant woman who has had at least one previous pregnancy.
Multigravida
Unspecified (hypertension)
upper appendicular skeleton
Greenstick
44. is a traumatic injury to a joint involving the soft tissue.
Contracted Rates with MCOs
Remittance Advice
sprain
Vesicle
45. This modifier is used to indicate that the procedure was done by an outside laboratory and not by the reporting facility or clinic.
Remittance Advice
Abuse
-90 - Reference (Outside) Laboratory
Medicare Claim Status
46. 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
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Accept assignment
Accident
The Integumentary System
47. Was developed to promote the interests and well being of the patients and residents of the healthcare facility. This bill has still not become a law.
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48. forms the roof of the nasal cavity.
Ethmoid Bone
Alphabetic Index (Volume 2)
Preferred Provider Organization (PPO)
Palatine bones
49. 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
Blue Cross/Blue Shield Plans
History of present illness (HPI)
Location Methods
50. Upper jaw bone
Peer Review Organization (PRO)
Outpatient
Contracted Rates with MCOs
Maxilla