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Test your basic knowledge |
Medical Billing And Coding Vocab
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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. This modifier is used to report a procedure or service that has more than one Modifier but the third-party payer does not allow the addition of multiple modifiers to the code. Modifier -99 is attached to the procedure code and the multiple Modifiers
Section 3 Index to External Causes of Injury (E codes)
-99 - Multiple Modifiers
Social Security Number
Established Patient
2. Under this schedule - a procedure's relative value is the sum total of three elements: Work: represents the amount of time - intensity of effort - and medical skill required of the physician. Overhead: practice costs related to the performing of the
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3. 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
MEDICARE Part B
Medical necessity
The Current Procedural Terminology (CPT)
Category III Codes CPT
4. 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
Abuse
Temporal Bone
bullet (a
Birthday rule
5. 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:
Pelvis
Hypertension Table
Fiscal Intermediary
Mutually Exclusive Edits
6. 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.
Unspecified nature
Coinsurance
History
Sesamoid bones
7. 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
Unauthorized benefit
Past - family and social history (PFSH)
Review of Systems (ROS)
Health Care Financing Administration Common Procedure Coding System
8. Is a fee that is charged for each procedure or service performed by the physician. This fee is obtained from a fee schedule - which is a list of charges or allowance that have accepted for specific medical services. The system in which fee schedules
Fee-for-Service
Assault
Hypertension Table
History of present illness (HPI)
9. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Abuse
Unauthorized benefit
Alopecia
Coding
10. anterior to the temporal bones.
Clean claim
Clean claim
Coordination of Benefits (COB)
Sphenoid Bones
11. Has all required fields accurately filled out - contains no deficiencies and passes all edits. The carrier does not require investigation outside of the carrier's operation before paying the claim.
Rejected claim
Health practitioner
Clean claim
History
12. A pregnant woman who has had at least one previous pregnancy.
Invalid claim
Multigravida
Benign (hypertension)
TRICARE PLANS
13. 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).
Carpals
Health Insurance Portability and Accountability Act (HIPAA)
Chapters
Mutually Exclusive Edits
14. This modifier is used to indicate that the procedure was done by an outside laboratory and not by the reporting facility or clinic.
False Claims Act (FCA)
Modifiers
-90 - Reference (Outside) Laboratory
co-payment
15. 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).
The Universal Claim Form
Clearinghouse
Chapters
Complicated
16. Lower portion of the pelvic bone
Sebaceous glands
Ischium
Sesamoid bones
-51 - Multiple Procedures
17. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Medical Records
Chief complaint
Collagen
Two triangular symbols (a
18. 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.
Deductible
upper appendicular skeleton
Employer Identification Number (EIN)
Retention of Medical Records
19. Superior and widest bone
False ribs
There are three layers to the skin
Preferred Provider plan
Pelvis
20. 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
Physician
Full ROM
Sebaceous glands
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
21. Under this schedule - a procedure's relative value is the sum total of three elements: Work: represents the amount of time - intensity of effort - and medical skill required of the physician. Overhead: practice costs related to the performing of the
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22. Provide a four-digit code (one digit after the decimal point) which is more specific than category code (3-digit) in terms of cause - site - or manifestation of the condition. This must be used if available. From subcategory - specificity moves to an
Pelvis
Salter-Harris
Subcategories
MEDICARE Part D
23. 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.
Polyp
Medicaid
Medical Records
Compliance Regulations
24. The skin and its accessory organs.Integument means covering. The skin covers over an area of 22 square feet ( an average adult). It is a complex system of specialized tissues containing glands - nerves and blood vessels. The main function of the skin
Sections
essential modifiers
sebaceous(oil) glands and the suddoriferous (sweat) glands
The Integumentary System
25. 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
-51 - Multiple Procedures
Ischium
Consultation
26. The lower anterior part of the bone
Melanin
Pubic bone
-26 - Professional Component
Colles
27. 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.
Pre-determination
Established Patient
Mutually Exclusive Edits
Humerus
28. Was created to provide medical benefits to spouses and children of veterans with total - permanent service related disabilities or for surviving spouses and children of a veteran who died as a result of service-related disability. It is a service ben
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
encounter form
New Patient
Health Care Financing Administration Common Procedure Coding System
29. 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
Peer Review Organization (PRO)
Long bones
Spinal/Vertebral Column
Patient Confidentiality
30. paired bones at the corner of each eye that cradle the tear ducts.
Add-on codes
Subcategories
Lacrimal bones
Fiscal Intermediary
31. Was created to provide medical benefits to spouses and children of veterans with total - permanent service related disabilities or for surviving spouses and children of a veteran who died as a result of service-related disability. It is a service ben
Vesicle
-26 - Professional Component
Tabular List (Volume 1)...
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
32. major skin pigment
Uncertain behavior
Melanin
Pelvis
Medically needy
33. A fracture of the epiphyseal plate in children.
Commercial Carriers
The Patient Care Partnership (Patient's Bill of Rights)
Salter-Harris
-90 - Reference (Outside) Laboratory
34. - 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
circle with a line through it)
Medigap (Medicare Supplemental Insurance)
Long bones
Group Insurance
35. open sore on the skin or mucous
TRICARE
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Relative Value Payment Schedules Method
Ulcermembranes
36. Is a policy that covers losses to a third party caused by the insured - by an object owned by the insured - or on premises owned by the insured. Liability insurance claims are made to cover the cost of medical care for traumatic injuries - lost wages
Liability insurance
Flat bones
Employee Liability
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
37. 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
Medicare
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Medigap (Medicare Supplemental Insurance)
Abuse
38. 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.
Group practice
Preferred Provider plan
Personal Insurance
No ROM
39. Eccrine sweat glands are the most common and the apocrine sweat glands that secrete an odorless sweat.
There are two types of sweat glands
Physician
HCPCS Level I codes
itemized statement
40. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.
Provider Identification Number (PIN)
Peer Review Organization (PRO)
Maxilla
Workers Compensation
41. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Impetigo
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Spinal/Vertebral Column
42. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
Long bones
axial skeleton
Pubic bone
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
43. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
-26 - Professional Component
Sesamoid bones
Impetigo
Indemnity Insurance
44. requires investigation and needs further clarification.
Rejected claim
Pre-paid Health Plan
Pelvis
Neoplasm Table
45. Pre-determined set of benefits covered under one set annual fee.
ligaments
The Patient Care Partnership (Patient's Bill of Rights)
Greenstick
Pre-paid Health Plan
46. The physician must obtain this number in order to practice within a state.
The Good Samaritan Act
Impetigo
Sections
State License Number
47. Small collection of clear fluid;blister
Short bones
Collagen
Vesicle
Mandible
48. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
Categories
Fiscal Intermediary
Pathologic
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
49. numbers 8-10 - are attached to the sternum by cartilage
Nodule
False ribs
Medicare Claim Status
Parietal Bones
50. 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.
Sphenoid Bones
Advance Beneficiary Notice
Outpatient
Inpatient