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Test your basic knowledge |
Medical Billing And Coding Vocab
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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. - 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
Fiscal Intermediary
Two triangular symbols (a
Multigravida
Medigap (Medicare Supplemental Insurance)
2. Used for procedures that is always performed during the same operative session as another surgery in addition to the primary service/procedure and is never performed separately.
Pre-paid Health Plan
-90 - Reference (Outside) Laboratory
Add-on codes
Liability insurance
3. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
New patient
Established Patient
Participating physician
Unspecified nature
4. 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 -
Pelvis
essential modifiers
Melanin
Location Methods
5. Small collection of clear fluid;blister
Malignant
Vesicle
CPT SECTIONS.
upper appendicular skeleton
6. This is any procedure or service reported on the insurance claim that is not listed in the payer's master benefit list. This will result in the denial of the claim. Providers may be able to recover the charges from the patient.
Social Security Number
CPT SECTIONS.
Non-covered benefit
Social Security Number
7. Structural protein found in the skin and connective tissue
Collagen
No ROM
HCPCS Level I codes
Retention of Medical Records
8. 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
Humerus
Flat bones
The Current Procedural Terminology (CPT)
Nonparticipating physician
9. Deficient in pigment (melanin)
Albino
Disability insurance
Medigap (Medicare Supplemental Insurance)
circle with a line through it)
10. 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.
Zygoma
Melanin
Retention of Medical Records
Macule
11. 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.
New Patient
Suicide Attempt
National Correct Coding Initiative (NCCI)
Review of Systems (ROS)
12. Used for procedures that is always performed during the same operative session as another surgery in addition to the primary service/procedure and is never performed separately.
Add-on codes
History
Mutually Exclusive Edits
Secondary malignancy
13. 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
-32 - Mandated Services
The Integumentary System
Occipital Bone
A plus sign (+)
14. Bone that forms posterior/inferior part of the nasal septal wall between the nostrils.
False Claims Act (FCA)
Chief complaint (CC)
Vomer
History
15. 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
premium
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Chief complaint
Workers Compensation
16. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Section 3 Index to External Causes of Injury (E codes)
Mutually Exclusive Edits
-26 - Professional Component
Peer Review Organization (PRO)
17. Are supplementary classification codes used to identify health care encounters that occur for reasons other than illness or injury or to identify patients whose illness is influenced by special circumstances or problems. The codes can be found in bot
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
MEDICAID COVERAGE
Blue Cross/Blue Shield Plans
New patient
18. Is the type of plan a patient may have where they can see providers outside their plan. The patient is responsible to pay the higher portion of the fee.
Provider Identification Number (PIN)
MEDICAID COVERAGE
Preferred Provider plan
Chapters
19. 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
axial skeleton
Pre-authorization
Liability insurance
False ribs
20. 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 -
Established patient
triangle (a
Health Maintenance Organization (HMO)
essential modifiers
21. Is the lower medial arm bone.
ligaments
Add-on codes
Alphabetic Index (Volume 2)
ulna
22. Is a managed care benefits plan that provides a wide range of medical services to individuals that have been enrolled into the program. It is generally the least costly but at the same time also the most restrictive. This plan uses a gatekeeper physi
Limited ROM
Health Maintenance Organization (HMO)
Melanin
Carcinoma (Ca) in situ
23. Mild or controlled hypertension and no damage to the vascular system or organs.
Pre-paid Health Plan
Performing Provider Identification Number (PPIN)
Benign (hypertension)
Qualified diagnosis
24. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
Neoplasm Table
The Good Samaritan Act
Section 3 Index to External Causes of Injury (E codes)
Deductible
25. A chronological account of the development of the complaint from the first sign or symptom that the patient experienced to the present
History of present illness (HPI)
Benign
Patient Confidentiality
Malignant
26. Pre-determined set of benefits covered under one set annual fee.
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Pre-paid Health Plan
MEDICAID COVERAGE
Liability insurance
27. forms the two lower sides of the cranium.
Carpals
Temporal Bone
lunula
HCPCS Level II codes (National Codes)
28. A fat cell
Fraud
Fee Schedule
-99 - Multiple Modifiers
Lipocyte
29. 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
CPT SECTIONS.
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Albino
Health Care Financing Administration Common Procedure Coding System
30. 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
Chief complaint
Sphenoid Bones
Pelvis
31. Is the qualifying factor or factors that must be met before a patient receives benefits.
Category II Codes CPT
Nonparticipating physician
Workers Compensation
Eligibility
32. This modifier is used when the same procedure is performed on a mirror-image part of the body..
New patient
-50 - Bilateral Procedure
Radius
Established Patient
33. - 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.
Unauthorized benefit
Medicaid
Vesicle
itemized statement
34. 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
Deductible
-99 - Multiple Modifiers
premium
The Universal Claim Form
35. 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.
The Universal Claim Form
Modifiers
Advance Beneficiary Notice
-51 - Multiple Procedures
36. is a traumatic injury to a joint involving the soft tissue.
Categories
Disability insurance
sprain
ligaments
37. consists of 17 chapters based on either body system or cause or type of disease. The codes range from 001-999.
premium
Tabular List (Volume 1)...
Category I Codes CPT
Alphabetic Index (Volume 2)
38. 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.
Employer Liability
Malignant
-32 - Mandated Services
Invalid claim
39. A minor fracture appears as a thin line on x-ray and may not extend completely through the bone.
Impacted
Add-on codes
TRICARE PLANS
Hairline
40. 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 -
Add-on codes
Indemnity Insurance
Abuse
Greenstick
41. contains errors or omissions. Usually - these claims do not pass front-end edits. They are either processed manually for resolving problems - or rejected for payment.
Coding
Impacted
Chief complaint
Dirty claim
42. Is the upper arm bone.
Musculoskeletal System
Humerus
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Liability insurance
43. 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.
History of present illness (HPI)
New patient
true ribs
Medical necessity
44. death of tissue associated with loss of blood supply
Eligibility
Review of Systems (ROS)
Invalid claim
Gangrene
45. 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
Subcategories
Capitated Rates
Secondary malignancy
Liability insurance
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
TRICARE PLANS
State License Number
Surgical Package
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
47. Small collection of clear fluid;blister
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Vesicle
The Universal Claim Form
itemized statement
48. 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
Nonparticipating physician
TRICARE
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Radius
49. Produce secretions that allow the body to be moisturized or cooled.
Patient Confidentiality
Indemnity Insurance
sebaceous(oil) glands and the suddoriferous (sweat) glands
Alopecia
50. Make up part of the interior of the nose.
Social Security Number
essential modifiers
Liability insurance
Inferior nasal conchae