SUBJECTS
|
BROWSE
|
CAREER CENTER
|
POPULAR
|
JOIN
|
LOGIN
Business Skills
|
Soft Skills
|
Basic Literacy
|
Certifications
About
|
Help
|
Privacy
|
Terms
|
Email
Search
Test your basic knowledge |
Medical Billing And Coding Vocab
Start Test
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. Superior and widest bone
Pelvis
There are three layers to the skin
Social Security Number
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
2. Represent changes in the text or definition between the triangles.
Two triangular symbols (a
Coinsurance
Employer Identification Number (EIN)
ulna
3. 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.
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Impetigo
Uncertain behavior
HCPCS Level II codes (National Codes)
4. This is the traditional method used by providers for submission of charges to insurance companies. The most commonly used form is the CMS-1500. Few plans still accept the physician's encounter form or superbill and Medicare will only accept claims on
Uncertain behavior
HCPCS Level I codes
Fee-for-Service
Paper Claim
5. Make up part of the interior of the nose.
Vomer
Preferred Provider plan
Birthday rule
Inferior nasal conchae
6. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.
Indemnity Insurance
Participating physician
axial skeleton
Assault
7. 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
State License Number
Benign (hypertension)
Pelvis
Accident
8. Is the upper arm bone.
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Carcinoma (Ca) in situ
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Humerus
9. Forms the sides of the cranium
Coordination of Benefits (COB)
Modifiers
Parietal Bones
Performing Provider Identification Number (PPIN)
10. 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
Non-covered benefit
State License Number
Medigap (Medicare Supplemental Insurance)
11. consists of 17 chapters based on either body system or cause or type of disease. The codes range from 001-999.
Category I Codes CPT
Alopecia
nonessential modifiers
Tabular List (Volume 1)...
12. 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.
Humerus
Pre-determination
Outpatient
Accept assignment
13. Are a group of independently licensed local companies - usually nonprofit that contracts with physicians and other health entities to provide services to their insured companies and individuals. Most BC/BS plans offer HMO's - PPO's and POS plans. Blu
Fraud
bullet (a
Radius
Blue Cross/Blue Shield Plans
14. The bones are connected to one another by fibrous bands of tissue . Muscles are attached to the bone by tendons. The fibrous covering of the muscles is called the fascia
Albino
Benign
Performing Provider Identification Number (PPIN)
ligaments
15. 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
New patient
Two triangular symbols (a
Chief complaint (CC)
16. 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)
Established Patient
TRICARE PLANS
nonessential modifiers
17. represents Exemption from the use of modifier -51
appendicular skeleton .
stand-alone codes
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
circle with a line through it)
18. 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
Evaluation and Management Review
The Universal Claim Form
Medical necessity
Sections
19. 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
Tabular List (Volume 1)...
Wheal
Coinsurance
HCPCS Level II codes (National Codes)
20. Upper jaw bone
Employer Liability
Medical Records
Maxilla
Limited ROM
21. This is the traditional method used by providers for submission of charges to insurance companies. The most commonly used form is the CMS-1500. Few plans still accept the physician's encounter form or superbill and Medicare will only accept claims on
Ethmoid Bone
Paper Claim
Compliance Regulations
Patient Confidentiality
22. A chronological account of the development of the complaint from the first sign or symptom that the patient experienced to the present
Participating physician
ligaments
New patient
History of present illness (HPI)
23. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.
Mutually Exclusive Edits
Peer Review Organization (PRO)
Personal Insurance
Palatine bones
24. Families - pregnant women - and children ;Aid to Families with Dependent Children (AFDC)-related groups ;Non-AFDC pregnant women and children;Aged and disabled persons ;Supplemental Security Income (SSI)-related groups ;Qualified Medicare Beneficiari
essential modifiers
Medicaid
Parietal Bones
Categorically needy -MEDICAID
25. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients
upper appendicular skeleton
HCPCS Level II codes (National Codes)
HCPCS Level I codes
MEDICARE Part A
26. 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.
Inpatient
Medigap (Medicare Supplemental Insurance)
Multigravida
Categorically needy -MEDICAID
27. Considered experimental - newly approved - or seldom used may not be listed in the CPT manual. These codes can be coded as unlisted procedures. They are located at the end of the subsections or subheadings. When an unlisted procedure code is reported
Uncertain behavior
Group practice
Unlisted Procedures Procedures
Section 3 Index to External Causes of Injury (E codes)
28. 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.
-26 - Professional Component
Established Patient
Melanin
Full ROM
29. '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
Liability insurance
Fraud
Maxilla
Employee Liability
30. Medicare Managed Care Plans (Formerly Medicare Plus (+) Choice Plan) was created to offer a number of healthcare services in addition to those available under Part A and Part B. The CMS contracts with managed care plans or provider service organizati
False Claims Act (FCA)
Humerus
MEDICARE Part C
Blue Cross/Blue Shield Plans
31. 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
Neoplasm Table
Medical necessity
Musculoskeletal System
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
32. A pregnant woman who has had at least one previous pregnancy.
eponychium
Multigravida
Employer Liability
Two triangular symbols (a
33. 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
Medicaid
Accident
Uncertain behavior
Sebaceous glands
34. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
Wheal
Full ROM
Secondary malignancy
Medically needy
35. 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.
Medical Records
False Claims Act (FCA)
MEDICAID COVERAGE
encounter form
36. This is the inventory of the constitutional symptoms regarding the various body systems.
Review of Systems (ROS)
The Current Procedural Terminology (CPT)
Mandible
Nonparticipating physician
37. 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
-26 - Professional Component
Employer Identification Number (EIN)
Category II Codes CPT
38. HCPCS Reference Manual The CMS assigns a standard unique identifier known as the National Provider Identifier (NPI) The CMS also developed a two-part coding system called the Healthcare Common Procedure Coding System ( HCPCS ) which is a collection o
Health Care Financing Administration Common Procedure Coding System
Point-of-Service plan (POS)
Contracted Rates with MCOs
Disability insurance
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
Malignant
History of present illness (HPI)
sprain
40. 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)
essential modifiers
Suicide Attempt
Social Security Number
41. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients
Outpatient
HCPCS Level I codes
Hypertension Table
Medically needy
42. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
Fiscal Intermediary
Relative Value Payment Schedules Method
Medical Records
Alphabetic Index (Volume 2)
43. Indicates add-on codes
Nonparticipating physician
Sebaceous glands
A plus sign (+)
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
44. 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.
Medical necessity
Abuse
Evaluation and Management Review
Section 3 Index to External Causes of Injury (E codes)
45. 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
Group practice
Capitated Rates
stand-alone codes
Comminuted fracture
46. 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.
-26 - Professional Component
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Subcategories
Assault
47. Contains complete - necessary information - but is incorrect or illogical in some way.
Outpatient
Invalid claim
Palatine bones
Group Insurance
48. Are composed of three-digit codes representing a single disease or condition.
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Carpals
Albino
Categories
49. Any fracture occurring spontaneously as a result of disease.
Pathologic
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
true ribs
Suicide Attempt
50. Forms the anterior part of the skull and the forehead
Frontal Bone
There are two types of sweat glands
Collagen
Clean claim