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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. The moon like white area at the base of the nail.
Health Care Financing Administration Common Procedure Coding System
Flat bones
Comminuted fracture
lunula
2. the bone is broken and the ends are driven into each other.
Colles
Impacted
ulna
Palatine bones
3. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called
Keratin
Melanin
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Ischium
4. The Usual - Customary - and Reasonable: The UCR method is used mostly in reference to fee-for-service reimbursement. To arrive at a payment amount for a claim - the carrier compares: The physician's most frequent charge for a given service (the usual
Fee Schedule
Sphenoid Bones
National Correct Coding Initiative (NCCI)
essential modifiers
5. Produce secretions that allow the body to be moisturized or cooled.
Secondary malignancy
Vesicle
sebaceous(oil) glands and the suddoriferous (sweat) glands
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
6. 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
Fissure
Medical Records
Sebaceous glands
Impetigo
7. Is a working diagnosis which is not yet established.
Subcategories
Clearinghouse
Qualified diagnosis
Nodule
8. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the
Categorically needy -MEDICAID
Peer Review Organization (PRO)
Vesicle
MEDICARE Part A
9. solid - round or oval elevated lesion more than 1 cm in diameter
MEDICARE Part B
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Complicated
Nodule
10. Noninvasive - non-spreading - nonmalignant
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Occipital Bone
Contracted Rates with MCOs
Benign
11. Upper jaw bone
Maxilla
Remittance Advice
premium
CPT SECTIONS.
12. Are composed of three-digit codes representing a single disease or condition.
Commercial Carriers
Categories
Musculoskeletal System
circle with a line through it)
13. 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).
Chapters
Undetermined
Fissure
Radius
14. Includes - but is not limited to - physician assistant - certified nurse-midwife - qualified psychologist - nurse practitioner - clinical social worker - physical therapist - occupational therapist - respiratory therapist - certified registered nurse
Capitated Rates
Health practitioner
MEDICARE Part C
Column 1/Column 2 (previously called Comprehensive/Component) Edits
15. forms the two lower sides of the cranium.
Clearinghouse
Temporal Bone
Medicaid
Impacted
16. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body
Greenstick
Secondary malignancy
Performing Provider Identification Number (PPIN)
Fee-for-Service
17. Is the cost of insurance coverage paid annually - semi-annually or monthly to keep a policy in effect.
premium
Capitated Rates
MEDICARE Part D
MEDICARE Part A
18. Indicates add-on codes
Evaluation and Management Review
Gender rule
Health Care Financing Administration Common Procedure Coding System
A plus sign (+)
19. solid - round or oval elevated lesion more than 1 cm in diameter
Impacted
CPT SECTIONS.
Nodule
Long bones
20. 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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21. Is a requirement for some health insurance plans to obtain permission for a service or procedure before it is done. It indicates that a specific procedure or service is deemed 'medically necessary'.
-26 - Professional Component
New patient
Pre-authorization
ulna
22. 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.
Health Insurance Portability and Accountability Act (HIPAA)
Dirty claim
Greenstick
Vesicle
23. A physician has a separate PPIN for each group office/clinic in which he or she practices. In the Medicare program - in addition to a group number - each member of a group is issued an 8-character performing provider identification number.
Impetigo
Palatine bones
Suicide Attempt
Performing Provider Identification Number (PPIN)
24. 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
Clearinghouse
There are two types of sweat glands
The Good Samaritan Act
False ribs
25. death of tissue associated with loss of blood supply
There are three layers to the skin
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Gangrene
circle with a line through it)
26. requires investigation and needs further clarification.
Eligibility
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Inferior nasal conchae
Rejected claim
27. 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)
History
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Impacted
co-payment
28. Are composed of three-digit codes representing a single disease or condition.
Categories
Primary malignancy
MEDICARE Part A
Unique Provider Identification Number (UPIN)
29. The cuticle at the lower part of the nail and this is sometimes referred to as the
HCPCS Level II codes (National Codes)
The Good Samaritan Act
eponychium
Short bones
30. 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
Pre-paid Health Plan
False Claims Act (FCA)
MEDICARE Part B
MEDICAID COVERAGE
31. 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
MEDICAID COVERAGE
Undetermined
Vomer
Inferior nasal conchae
32. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
Flat bones
circle with a line through it)
Carcinoma (Ca) in situ
-90 - Reference (Outside) Laboratory
33. Typically not used on the claim form unless the provider does not have an EIN.
Clean claim
Category III Codes CPT
Social Security Number
New Patient
34. 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
Carcinoma (Ca) in situ
Location Methods
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Deductible
35. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Lipocyte
Employer Identification Number (EIN)
Explanation of Benefits (EOB)
Unspecified nature
36. 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 -
Qualified diagnosis
Health Insurance Portability and Accountability Act (HIPAA)
Preferred Provider plan
Indemnity Insurance
37. 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
Pre-authorization
Pre-paid Health Plan
essential modifiers
MEDICAID COVERAGE
38. Poisoning cannot be determined whether intentional or accidental.
Undetermined
Unspecified nature
Social Security Number
-99 - Multiple Modifiers
39. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
Personal Insurance
premium
Capitated Rates
Impetigo
40. 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.
Complicated
-26 - Professional Component
False Claims Act (FCA)
Employer Identification Number (EIN)
41. 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
Section 3 Index to External Causes of Injury (E codes)
Established Patient
Coinsurance
42. forms the roof of the nasal cavity.
Ethmoid Bone
Parietal Bones
ligaments
Zygoma
43. 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
Section 3 Index to External Causes of Injury (E codes)
History of present illness (HPI)
Disability insurance
Chief complaint
44. Mild or controlled hypertension and no damage to the vascular system or organs.
Lacrimal bones
The Universal Claim Form
Benign (hypertension)
Unique Provider Identification Number (UPIN)
45. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
Colles
Ischium
Spinal/Vertebral Column
Fiscal Intermediary
46. 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
Group practice
Fissure
MEDICARE Part C
Lipocyte
47. 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
Categories
Medicaid
Fee Schedule
-99 - Multiple Modifiers
48. Mild or controlled hypertension and no damage to the vascular system or organs.
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Benign (hypertension)
Fraud
Explanation of Benefits (EOB)
49. are composed of a group of three-digit categories representing a group of conditions or related conditions; they are divided into categories. e.g. . - Disorders of Thyroid Gland (240 - 246).
Sections
Birthday rule
Subcategories
Preferred Provider plan
50. 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)
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
The Universal Claim Form
Surgical Package