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Test your basic knowledge |
Medical Billing And Coding Vocab
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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. Make up part of the interior of the nose.
lunula
Inferior nasal conchae
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Provider Identification Number (PIN)
2. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
Explanation of Benefits (EOB)
Personal Insurance
Review of Systems (ROS)
Impetigo
3. Indicates add-on codes
Group Insurance
Malignant
A plus sign (+)
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
4. 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
Sphenoid Bones
Primary malignancy
Retention of Medical Records
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
5. Numbers 1-7 - attach directly to the sternum in the front of the body.
eponychium
Chief complaint
true ribs
Health Insurance Portability and Accountability Act (HIPAA)
6. Is a patient who receives treatment in any of the following settings: physician's office ;hospital clinic - emergency department - hospital same-day surgery unit - ambulatory surgical center ( patient is released within 23 hours) ;hospital admission
Mandible
Alopecia
The Current Procedural Terminology (CPT)
Outpatient
7. most synarthroses are immovable joints held together by fibrous tissue.
Occipital Bone
No ROM
New patient
Albino
8. the bone is crushed and or shattered.
Comminuted fracture
Rib Cage
ulna
Liability insurance
9. Pre-determined set of benefits covered under one set annual fee.
Compliance Regulations
Pre-paid Health Plan
Inferior nasal conchae
There are three layers to the skin
10. Contain the full description of the procedure for the code indented codes: these are codes listed under associated stand-alone codes. To complete the description for indented codes - one must refer to the portion of the stand alone code description b
stand-alone codes
Pelvis
Salter-Harris
Rejected claim
11. 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
Ischium
The Current Procedural Terminology (CPT)
Hypertension Table
The Integumentary System
12. 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
Hairline
Pelvis
axial skeleton
13. 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 -
Remittance Advice
premium
Indemnity Insurance
Fraud
14. The fractured area of bone collapses on itself.
Alopecia
Unlisted Procedures Procedures
Ethmoid Bone
Compression fracture
15. Are composed of three-digit codes representing a single disease or condition.
Accept assignment
Commercial Carriers
Categories
Liability insurance
16. When a group of employees and their dependents are insured under one (1) group policy issued to the employer. Generally - the employer pays the premium or a portion of the premium and the employee pays the difference. This all depends on the type of
Unlisted Procedures Procedures
Group Insurance
Chief complaint (CC)
Medicare Claim Status
17. 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.
circle with a line through it)
stand-alone codes
Retention of Medical Records
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
18. 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
Unspecified (hypertension)
Occipital Bone
TRICARE
MEDICARE Part B
19. Any fracture occurring spontaneously as a result of disease.
Keratin
Commercial Carriers
Pathologic
Non-covered benefit
20. Mild or controlled hypertension and no damage to the vascular system or organs.
Greenstick
State License Number
There are three layers to the skin
Benign (hypertension)
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'.
The Patient Care Partnership (Patient's Bill of Rights)
Pre-authorization
Established Patient
-51 - Multiple Procedures
22. 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.
Modifiers
Nodule
Zygoma
Medicaid
23. Represents a new procedure or service code added since the previous edition of the manual.
triangle (a
Lacrimal bones
bullet (a
upper appendicular skeleton
24. Also called 'global surgery' - includes a variety of services rendered by a surgeon which includes the following: Surgical procedure performed Local infiltration - metacarpal/metatarsal/digital block - or topical anesthesia Preoperative E/M services
Nodule
Group Provider Number
Surgical Package
Long bones
25. Contains complete - necessary information - but is incorrect or illogical in some way.
Invalid claim
Relative Value Payment Schedules Method
MEDICARE Part D
Polyp
26. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
Unique Provider Identification Number (UPIN)
lunula
Malignant
Health Insurance Portability and Accountability Act (HIPAA)
27. Is one who has no contract with the health insurance plan.
-90 - Reference (Outside) Laboratory
Section 3 Index to External Causes of Injury (E codes)
Nonparticipating physician
Sub classification
28. 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.
Clearinghouse
National Correct Coding Initiative (NCCI)
Remittance Advice
MEDICARE Part B
29. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
Fiscal Intermediary
Full ROM
New patient
Performing Provider Identification Number (PPIN)
30. The CPT manual is composed of eight sections. Each section begins with guidelines that provide specific coding rules for that section. Guidelines at the beginning of the section are applicable to all codes in the section - while notes that pertain t
Subcategories
Sections
MEDICARE Part A
CPT SECTIONS.
31. 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.
Mandible
Maxilla
Musculoskeletal System
Add-on codes
32. Groove or crack like sore
Fissure
Limited ROM
Social Security Number
essential modifiers
33. 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
Medicare
Health Maintenance Organization (HMO)
itemized statement
Retention of Medical Records
34. Deficient in pigment (melanin)
Albino
Long bones
Categories
History
35. 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
Undetermined
Unlisted Procedures Procedures
Social Security Number
Multigravida
36. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Mutually Exclusive Edits
stand-alone codes
Modifiers
Pathologic
37. Is an electronic or paper-based report of payment sent by the payer to the provider.
Occipital Bone
There are three layers to the skin
Remittance Advice
Disability insurance
38. This is a set of information the physician gathers from the patient regarding the following:
HCPCS Level II codes (National Codes)
Short bones
Patient Confidentiality
History
39. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Primary malignancy
Unspecified nature
There are two types of sweat glands
Consultation
40. 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
Dirty claim
Benign (hypertension)
Medical Records
Fraud
41. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
stand-alone codes
Ischium
Accept assignment
Undetermined
42. 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
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
The Current Procedural Terminology (CPT)
Category II Codes CPT
Medical Records
43. This is a set of information the physician gathers from the patient regarding the following:
History
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Macule
eponychium
44. To report a circumstance in which the physician returns to the operating room to address a complication stemming from the initial procedure - modifier -78 is attached to the subsequent procedure code.
Carcinoma (Ca) in situ
Greenstick
Gender rule
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
45. 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
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Nodule
Past - family and social history (PFSH)
Long bones
46. It is important that every patient seen by the physician has comprehensive legible documentation about the patient's illness - treatment and plans for the following reasons Avoidance of denied or delayed payments by insurance carriers investigating t
Fee-for-Service
Peer Review Organization (PRO)
Reasons for Documentation
Alphabetic Index (Volume 2)
47. Discolored - flat lesion (freckles - tattoo marks)
There are two types of sweat glands
Personal Insurance
Macule
Complicated
48. 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
appendicular skeleton .
Paper Claim
Polyp
Maxilla
49. consists of 17 chapters based on either body system or cause or type of disease. The codes range from 001-999.
nonessential modifiers
Tabular List (Volume 1)...
New patient
MEDICARE Part B
50. Is a statement of the patient's account history - showing dates of service - detailed charges - payments (i.e. deductibles and co-pays) - the date the insurance claim was submitted - applicable adjustments and account balance.
Uncertain behavior
Uncertain behavior
itemized statement
Dirty claim