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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. This is the index for the E codes.It classifies - in alphabetical order - environmental events and other conditions as the cause of injury and other adverse effects.
Health Maintenance Organization (HMO)
Section 3 Index to External Causes of Injury (E codes)
There are two types of sweat glands
Maxilla
2. 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.
Group Insurance
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Preferred Provider plan
3. This involves the use of relative value scales which assign a relative weight to individual services according to the basis for the scale. Services that are more difficult - time consuming - or resource intensive to perform typically have higher rela
Relative Value Payment Schedules Method
Mutually Exclusive Edits
Occipital Bone
Accident
4. 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
Personal Insurance
Consultation
Ulcermembranes
Clearinghouse
5. 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
Disability insurance
Health Care Financing Administration Common Procedure Coding System
No ROM
Patient Confidentiality
6. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called
Impetigo
sprain
Vesicle
Keratin
7. Make up part of the interior of the nose.
Provider Identification Number (PIN)
Health practitioner
Unspecified nature
Inferior nasal conchae
8. Number assigned by the insurance company to a physician who renders services to patients.
Sesamoid bones
Polyp
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Provider Identification Number (PIN)
9. Represents a change in the code description since the last edition. The change may be minor or significant and it could be an addition - deletion or revision.
Health Insurance Portability and Accountability Act (HIPAA)
Medigap (Medicare Supplemental Insurance)
False Claims Act (FCA)
triangle (a
10. the bone is broken and the ends are driven into each other.
Impacted
circle with a line through it)
Deductible
Collagen
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
Vomer
circle with a line through it)
Musculoskeletal System
stand-alone codes
12. are small with irregular shapes. They are found in the wrist and ankle.
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Short bones
Compliance Regulations
essential modifiers
13. Groove or crack like sore
National Correct Coding Initiative (NCCI)
Fissure
Peer Review Organization (PRO)
Sebaceous glands
14. 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
Relative Value Payment Schedules Method
Evaluation and Management Review
-50 - Bilateral Procedure
sprain
15. Forms the anterior part of the skull and the forehead
Performing Provider Identification Number (PPIN)
-32 - Mandated Services
Frontal Bone
Fee-for-Service
16. 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
Sesamoid bones
Greenstick
Deductible
17. Cheekbone
Zygoma
Relative Value Payment Schedules Method
Alopecia
Pre-certification
18. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Nonparticipating physician
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Unspecified nature
Primary malignancy
19. They are for profit organizations that operate in the private sector selling different health insurance benefits plans to groups or individuals. Most commercial plans have predefined patient yearly deductibles and coinsurance generally based on 80/2
Group Provider Number
Commercial Carriers
Point-of-Service plan (POS)
Civil Monetary Penalties Law (CMPL)
20. is a traumatic injury to a joint involving the soft tissue.
Peer Review Organization (PRO)
sprain
Chief complaint
Medicaid
21. 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.
Primary malignancy
Explanation of Benefits (EOB)
Long bones
Medical Records
22. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
nonessential modifiers
CPT SECTIONS.
Health Insurance Portability and Accountability Act (HIPAA)
Surgical Package
23. 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..
History of present illness (HPI)
Musculoskeletal System
-50 - Bilateral Procedure
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
24. Under capitation - the physician provides a full range of contracted services to covered patients for a fixed amount on a periodic basis. While guaranteed a fixed amount - the physician assumes the risk that the cost of providing the care to the pati
Pathologic
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Physician
Capitated Rates
25. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
Employer Identification Number (EIN)
Long bones
Workers Compensation
Subcategories
26. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Uncertain behavior
Category II Codes CPT
Suicide Attempt
Chief complaint
27. Upper jaw bone
Gender rule
Maxilla
A plus sign (+)
Evaluation and Management Review
28. All patients have a right to privacy and all information should remain privileged. Discuss patient information only with the patient's physician or office personnel that need certain information to do their job. Obtain a signed consent form to releas
Limited ROM
Participating physician
Sub classification
Patient Confidentiality
29. The cuticle at the lower part of the nail and this is sometimes referred to as the
eponychium
lunula
Full ROM
MEDICARE Part A
30. 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.
phalanges (phalanx.s)
Pubic bone
Medical Records
Flat bones
31. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
Temporal Bone
Rib Cage
ligaments
Spinal/Vertebral Column
32. 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.
MEDICARE Part C
Modifiers
TRICARE
Commercial Carriers
33. 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
CPT SECTIONS.
MEDICARE Part C
-32 - Mandated Services
Abuse
34. poisoning was inflicted by another person with intent to kill or injure
Advance Beneficiary Notice
Invalid claim
Assault
Medicare
35. Eccrine sweat glands are the most common and the apocrine sweat glands that secrete an odorless sweat.
Unspecified (hypertension)
Albino
There are two types of sweat glands
The Good Samaritan Act
36. 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.
Salter-Harris
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
A plus sign (+)
Pathologic
37. numbers 8-10 - are attached to the sternum by cartilage
Frontal Bone
Melanin
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
False ribs
38. uncertain whether benign or malignant; borderline malignancy
Uncertain behavior
There are three layers to the skin
Relative Value Payment Schedules Method
Health Care Financing Administration Common Procedure Coding System
39. Is defined by Medicare as 'the determination that a service or procedure rendered is reasonable and necessary for the diagnosis or treatment of an illness or injury.'
Medical necessity
Occipital Bone
Physician
Flat bones
40. includes the shoulder girdle which is made up of the scapula - clavicle and upper extremities. The scapula - or shoulder blades are flat bones that help support the arms. The clavicle - or collarbone - is curved horizontal bones that attach to the u
upper appendicular skeleton
TRICARE
Evaluation and Management Review
Ethmoid Bone
41. Represent changes in the text or definition between the triangles.
premium
Medicare
Two triangular symbols (a
stand-alone codes
42. This modifier is used when the same procedure is performed on a mirror-image part of the body..
essential modifiers
bullet (a
Hypertension Table
-50 - Bilateral Procedure
43. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Employer Identification Number (EIN)
Multigravida
Carpals
Qualified diagnosis
44. 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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45. 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
Nonparticipating physician
Point-of-Service plan (POS)
Preferred Provider Organization (PPO)
Group Insurance
46. 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
Birthday rule
-90 - Reference (Outside) Laboratory
-50 - Bilateral Procedure
Neoplasm Table
47. This involves the use of relative value scales which assign a relative weight to individual services according to the basis for the scale. Services that are more difficult - time consuming - or resource intensive to perform typically have higher rela
Peer Review Organization (PRO)
axial skeleton
Palatine bones
Relative Value Payment Schedules Method
48. Is the lateral lower arm bone (in line with the thumb).
Lacrimal bones
Radius
Patient Confidentiality
Disability insurance
49. Small collection of clear fluid;blister
Health Maintenance Organization (HMO)
Vesicle
Lacrimal bones
History
50. anterior to the temporal bones.
The Current Procedural Terminology (CPT)
TRICARE PLANS
Sphenoid Bones
Performing Provider Identification Number (PPIN)