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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.
If you are not ready to take this test, you can
study here
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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. Indicates add-on codes
ligaments
Exclusions and Limitations
A plus sign (+)
Fiscal Intermediary
2. Further classified as to primary - secondary - or carcinoma in situ.
Malignant
Modifiers
nonessential modifiers
Unique Provider Identification Number (UPIN)
3. Are composed of three-digit codes representing a single disease or condition.
Invalid claim
Medical Records
Categories
Fissure
4. Is made up of the shoulder - collar - pelvic and arms and legs
Nodule
appendicular skeleton .
Medicaid
MEDICARE Part C
5. The main term in the index may by followed by terms within parenthesis.
Ischium
Alphabetic Index (Volume 2)
Parietal Bones
-90 - Reference (Outside) Laboratory
6. 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
ligaments
upper appendicular skeleton
Vesicle
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
7. Consists of the skull - rib cage - and spine
Add-on codes
Unspecified nature
Malignant
axial skeleton
8. .. lower jaw bone.
-32 - Mandated Services
No ROM
Mandible
Limited ROM
9. 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
Spinal/Vertebral Column
-99 - Multiple Modifiers
Provider Identification Number (PIN)
Alopecia
10. Are the finger bones. Each finger has three phalanges - except for the thumb. The three phalanges are the proximal - middle and a distal phalanx. The thumb has a proximal and distal.
There are two types of sweat glands
phalanges (phalanx.s)
State License Number
Categorically needy -MEDICAID
11. Bone that forms posterior/inferior part of the nasal septal wall between the nostrils.
Polyp
Category II Codes CPT
Vomer
Rib Cage
12. 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.
Commercial Carriers
Sections
-32 - Mandated Services
Chief complaint
13. 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
Personal Insurance
Subcategories
Health practitioner
Clean claim
14. make up part of the roof of the mouth
Collagen
Palatine bones
triangle (a
Clearinghouse
15. 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
History of present illness (HPI)
Neoplasm Table
Dirty claim
Unauthorized benefit
16. paired bones at the corner of each eye that cradle the tear ducts.
Lacrimal bones
Abuse
Exclusions and Limitations
Pre-determination
17. A fracture of the epiphyseal plate in children.
MEDICARE Part A
Salter-Harris
The Current Procedural Terminology (CPT)
Category III Codes CPT
18. Cheekbone
Zygoma
Palatine bones
Macule
Advance Beneficiary Notice
19. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.
Participating physician
-26 - Professional Component
Electronic Claim
Inferior nasal conchae
20. Are codes formulated thru the joint efforts of the CMS - the Health Insurance Association of America - and the Blue Cross and Blue Shield Association. Level II contains five position alpha-numeric codes for physician and non-physician services not fo
Impetigo
There are three layers to the skin
Fee-for-Service
HCPCS Level II codes (National Codes)
21. Is the lower medial arm bone.
ulna
Gender rule
Coding
Keratin
22. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
The Current Procedural Terminology (CPT)
Unlisted Procedures Procedures
sebaceous(oil) glands and the suddoriferous (sweat) glands
Long bones
23. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Keratin
Alopecia
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
24. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
Fiscal Intermediary
Electronic Claim
Medicare
Vomer
25. 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.
Capitated Rates
Fraud
co-payment
-26 - Professional Component
26. This is not specified as benign or malignant in the diagnosis or medical record.
Unspecified (hypertension)
premium
Assault
Explanation of Benefits (EOB)
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
MEDICARE Part D
Unlisted Procedures Procedures
Abuse
Parietal Bones
28. Represents a new procedure or service code added since the previous edition of the manual.
Group Provider Number
No ROM
bullet (a
Explanation of Benefits (EOB)
29. 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.
Personal Insurance
nonessential modifiers
Medicare
Capitated Rates
30. 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....
The St. Anthony Relative Value for Physicians (RVP)
Qualified diagnosis
nonessential modifiers
Preferred Provider Organization (PPO)
31. 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 -
Consultation
Parietal Bones
Indemnity Insurance
New patient
32. the bone is broken and the ends are driven into each other.
Complicated
Health Care Financing Administration Common Procedure Coding System
Spinal/Vertebral Column
Impacted
33. Upper jaw bone
Categories
triangle (a
Group Provider Number
Maxilla
34. is a federal program administered by state governments to provide medical assistance to the needy. Each state sets its own guidelines for eligibility and services - therefore benefits and coverage may vary widely from state to state.
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Short bones
Medicaid
Alphabetic Index (Volume 2)
35. The poisoning was self-inflicted.
Suicide Attempt
Categories
Chief complaint
Pubic bone
36. 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....
Health Insurance Portability and Accountability Act (HIPAA)
Established patient
Humerus
Alopecia
37. There are also terms indented two spaces to the right below the main term called subterms. These subterms are because they have bearing in the selection of the right code. Everything in the Index is listed by condition - that is - diagnosis - signs -
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Gangrene
essential modifiers
Contracted Rates with MCOs
38. 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).
Full ROM
Unique Provider Identification Number (UPIN)
Pre-determination
Chapters
39. 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
Primary malignancy
Categories
ligaments
There are three layers to the skin
40. Mild or controlled hypertension and no damage to the vascular system or organs.
axial skeleton
The St. Anthony Relative Value for Physicians (RVP)
Benign (hypertension)
Fiscal Intermediary
41. Is a working diagnosis which is not yet established.
ulna
bullet (a
MEDICARE Part D
Qualified diagnosis
42. requires investigation and needs further clarification.
Rejected claim
Compression fracture
Inpatient
Provider Identification Number (PIN)
43. 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.
Accident
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
National Correct Coding Initiative (NCCI)
Pre-determination
44. 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
sebaceous(oil) glands and the suddoriferous (sweat) glands
Ulcermembranes
Blue Cross/Blue Shield Plans
Paper Claim
45. the bone is broken and the ends are driven into each other.
Impacted
Spinal/Vertebral Column
Civil Monetary Penalties Law (CMPL)
Coding
46. Standard - fee-for-service - cost-sharing plan ; Extra - preferred provider organization ;Prime - health maintenance organization plan with a point-of-service option All of the above-mentioned plans covered under TRICARE - with the exception of Prime
Pre-authorization
TRICARE PLANS
Retention of Medical Records
Employer Liability
47. Benign growth extending from the surface of the mucous membrane
False ribs
Polyp
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Workers Compensation
48. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
Wheal
Qualified diagnosis
Relative Value Payment Schedules Method
co-payment
49. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Albino
Paper Claim
Unspecified nature
Location Methods
50. death of tissue associated with loss of blood supply
Consultation
circle with a line through it)
Eligibility
Gangrene