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Test your basic knowledge |
Medical Billing And Coding Vocab
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Study First
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
.
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. The physician must obtain this number in order to practice within a state.
Remittance Advice
Secondary malignancy
State License Number
Salter-Harris
2. Indicates add-on codes
Keratin
A plus sign (+)
Coinsurance
premium
3. are small with irregular shapes. They are found in the wrist and ankle.
Consultation
History
Short bones
A plus sign (+)
4. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Pre-authorization
Chief complaint
MEDICARE Part D
Full ROM
5. Medicaid is the payer of last resort. If the patient has Medicare and Medicaid - Medicaid usually pays for the Medicare Part B deductible - coinsurance - and monthly premium amounts. Some of the services covered by Medicaid include the following: Inp
ulna
Unspecified (hypertension)
MEDICAID COVERAGE
There are two types of sweat glands
6. Are conditions - situations - and services not covered by the insurance carrier.
The Current Procedural Terminology (CPT)
Unauthorized benefit
Collagen
Exclusions and Limitations
7. 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
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Section 3 Index to External Causes of Injury (E codes)
HCPCS Level II codes (National Codes)
8. Is the qualifying factor or factors that must be met before a patient receives benefits.
Patient Confidentiality
Pubic bone
Salter-Harris
Eligibility
9. Represents a new procedure or service code added since the previous edition of the manual.
History of present illness (HPI)
nonessential modifiers
bullet (a
Exclusions and Limitations
10. Produce secretions that allow the body to be moisturized or cooled.
Health Insurance Portability and Accountability Act (HIPAA)
co-payment
sebaceous(oil) glands and the suddoriferous (sweat) glands
The Universal Claim Form
11. male of household is primary payer
Participating physician
Pathologic
Unique Provider Identification Number (UPIN)
Gender rule
12. forms the two lower sides of the cranium.
Inpatient
Temporal Bone
Occipital Bone
Suicide Attempt
13. Lower portion of the pelvic bone
Ischium
Comminuted fracture
The St. Anthony Relative Value for Physicians (RVP)
Hypertension Table
14. numbers 8-10 - are attached to the sternum by cartilage
False ribs
MEDICARE Part A
Coinsurance
Medigap (Medicare Supplemental Insurance)
15. Consists of the skull - rib cage - and spine
axial skeleton
Medical Records
Flat bones
New patient
16. Federal law that prohibits submitting a fraudulent claim or making a false statement or representation in connection with a claim. It also protects and rewards persons involved in whistle-blower cases.
False Claims Act (FCA)
Neoplasm Table
Inpatient
Two triangular symbols (a
17. Structural protein found in the skin and connective tissue
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Greenstick
Category I Codes CPT
Collagen
18. This modifier is used to indicate that the procedure was done by an outside laboratory and not by the reporting facility or clinic.
Chapters
Chief complaint (CC)
Mutually Exclusive Edits
-90 - Reference (Outside) Laboratory
19. is basically the same as HMO in the sense that the health care provider enters into contract with the MCOs to render services to the beneficiaries. However - PPO's charge a higher premium than HMO's in exchange for more flexibility and more options
Preferred Provider Organization (PPO)
Medicare Claim Status
itemized statement
Relative Value Payment Schedules Method
20. 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
premium
There are two types of sweat glands
Tabular List (Volume 1)...
upper appendicular skeleton
21. death of tissue associated with loss of blood supply
Gangrene
Point-of-Service plan (POS)
False Claims Act (FCA)
Gender rule
22. 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.
New Patient
Location Methods
Uncertain behavior
-32 - Mandated Services
23. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Electronic Claim
Vesicle
MEDICARE Part A
Unspecified nature
24. 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....
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Salter-Harris
The St. Anthony Relative Value for Physicians (RVP)
Long bones
25. 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.
Commercial Carriers
A plus sign (+)
Dirty claim
Unauthorized benefit
26. Bone that forms posterior/inferior part of the nasal septal wall between the nostrils.
Zygoma
Vomer
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Fissure
27. 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
essential modifiers
Abuse
upper appendicular skeleton
Fiscal Intermediary
28. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
ligaments
Benign
Preferred Provider plan
Health Insurance Portability and Accountability Act (HIPAA)
29. anterior to the temporal bones.
Sphenoid Bones
Health Care Financing Administration Common Procedure Coding System
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Ethmoid Bone
30. This number is used instead of the individual physician's number for the performing provider who is a member of a group practice that submits claims to insurance companies under the group name.
Group Provider Number
Sphenoid Bones
Location Methods
appendicular skeleton .
31. - 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.
Unlisted Procedures Procedures
Unauthorized benefit
Indemnity Insurance
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
32. Any fracture occurring spontaneously as a result of disease.
Blue Cross/Blue Shield Plans
Occipital Bone
Pathologic
-50 - Bilateral Procedure
33. Is the upper arm bone.
Humerus
Established patient
Impacted
Relative Value Payment Schedules Method
34. 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
Unlisted Procedures Procedures
Rejected claim
-90 - Reference (Outside) Laboratory
Liability insurance
35. These parenthetic terms are called because their presence or absence does not have an effect on the selection of the code listed for the main term.
Ischium
nonessential modifiers
The St. Anthony Relative Value for Physicians (RVP)
Pre-authorization
36. Knowingly and intentionally deceiving or misrepresenting information that may result in unauthorized benefits is known as fraud.. Common forms of fraud are billing for services not furnished - unbundling - and misrepresenting diagnosis to justify pay
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Unlisted Procedures Procedures
Electronic Claim
Fraud
37. 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
Sebaceous glands
-99 - Multiple Modifiers
Electronic Claim
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
38. 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
Group Insurance
Category II Codes CPT
New patient
39. 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.
Collagen
Lipocyte
sebaceous(oil) glands and the suddoriferous (sweat) glands
Medical Records
40. This modifier is used to explain that the procedure or service done during a postoperative period was planned at the time of the original procedure. This is also used if a therapeutic procedure is performed because of the findings from a diagnostic p
Rejected claim
Ethmoid Bone
Deductible
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
41. The main term in the index may by followed by terms within parenthesis.
Compliance Regulations
Benign
Alphabetic Index (Volume 2)
Inferior nasal conchae
42. The cuticle at the lower part of the nail and this is sometimes referred to as the
Electronic Claim
Reasons for Documentation
eponychium
Polyp
43. 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
Fissure
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
HCPCS Level II codes (National Codes)
44. Is a regionally managed healthcare program for active duty and retired members of the armed forces - their families - and survivors. It is a service benefit program and contains no premium. TRICARE is the new title for the CHAMPUS program (Civilian H
Advance Beneficiary Notice
TRICARE
Clearinghouse
Malignant
45. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.
Medical Records
Health Maintenance Organization (HMO)
-32 - Mandated Services
Greenstick
46. 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
Location Methods
False Claims Act (FCA)
Sebaceous glands
Medically needy
47. .. lower jaw bone.
HCPCS Level II codes (National Codes)
Medicare
Mandible
Accept assignment
48. is referred to as Supplementary Medical Insurance (SMI). This coverage is a supplement to Part A - which covers medical expenses - clinical laboratory services - home health care - outpatient hospital treatment - blood - and ambulatory surgical serv
Fee-for-Service
Gender rule
Participating physician
MEDICARE Part B
49. Benign growth extending from the surface of the mucous membrane
Indemnity Insurance
axial skeleton
Polyp
Exclusions and Limitations
50. The reason the patient came to see the physician.
Category III Codes CPT
Reasons for Documentation
Tabular List (Volume 1)...
Chief complaint (CC)