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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.
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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. Benign growth extending from the surface of the mucous membrane
Polyp
Patient Confidentiality
Group practice
stand-alone codes
2. Number assigned to the physician by Medicare program.
Clean claim
essential modifiers
MEDICARE Part C
Unique Provider Identification Number (UPIN)
3. 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.
New patient
Evaluation and Management Review
History
ligaments
4. Is the cost of insurance coverage paid annually - semi-annually or monthly to keep a policy in effect.
Neoplasm Table
Medicare
Ischium
premium
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
Fiscal Intermediary
Outpatient
MEDICAID COVERAGE
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
6. Poisoning was due to: Accidental overdose; Wrong substance taken; Accidents in use of drugs and biologicals; External causes of poisonings classifiable to 980-989 Therapeutic Use: instances when a correct substance properly taken is the cause of adve
Accident
Surgical Package
Dirty claim
Column 1/Column 2 (previously called Comprehensive/Component) Edits
7. 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.
Benign (hypertension)
HCPCS Level II codes (National Codes)
Pre-determination
New patient
8. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
-90 - Reference (Outside) Laboratory
essential modifiers
HCPCS Level II codes (National Codes)
Wheal
9. Numbers 1-7 - attach directly to the sternum in the front of the body.
Participating physician
State License Number
true ribs
Lipocyte
10. A minor fracture appears as a thin line on x-ray and may not extend completely through the bone.
Hairline
Greenstick
Contracted Rates with MCOs
Undetermined
11. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.
bullet (a
TRICARE PLANS
Unspecified nature
Participating physician
12. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
Malignant
No ROM
Alphabetic Index (Volume 2)
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
13. Is defined as someone who has received medical services with in the last 3 years from the physician or another physician of the same specialty who belongs to the same group practice.
Unique Provider Identification Number (UPIN)
Established Patient
Unique Provider Identification Number (UPIN)
Comminuted fracture
14. Physicians are legally responsible for their own conduct and any actions of their employees (their designee) performed within the context of their employment. This is referred to as 'vicarious liability -' also known as 'respondent superior -' which
Medicaid
False Claims Act (FCA)
Health practitioner
Employer Liability
15. is a traumatic injury to a joint involving the soft tissue.
Malignant
Flat bones
sprain
Remittance Advice
16. Superior and widest bone
Pelvis
Inferior nasal conchae
Palatine bones
Advance Beneficiary Notice
17. 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.
Malignant
Accident
Medigap (Medicare Supplemental Insurance)
phalanges (phalanx.s)
18. 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
Disability insurance
New patient
Benign
Unspecified nature
19. 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.
itemized statement
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Melanin
MEDICARE Part A
20. 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
Primary malignancy
Occipital Bone
ulna
21. This is defined as incidents or practices - not usually considered fraudulent - that are inconsistent with the accepted medical business or fiscal practices in the industry. Examples of abuse are submitting a claim for a service or procedure performe
stand-alone codes
The Patient Care Partnership (Patient's Bill of Rights)
Retention of Medical Records
Abuse
22. 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)
National Correct Coding Initiative (NCCI)
appendicular skeleton .
Commercial Carriers
23. poisoning was inflicted by another person with intent to kill or injure
upper appendicular skeleton
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Accept assignment
Assault
24. The bones are connected to one another by fibrous bands of tissue . Muscles are attached to the bone by tendons. The fibrous covering of the muscles is called the fascia
Palatine bones
ligaments
Short bones
Review of Systems (ROS)
25. represents Exemption from the use of modifier -51
Surgical Package
circle with a line through it)
The Current Procedural Terminology (CPT)
Maxilla
26. death of tissue associated with loss of blood supply
Gangrene
Sphenoid Bones
Pathologic
Participating physician
27. 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.
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Tabular List (Volume 1)...
Malignant
National Correct Coding Initiative (NCCI)
28. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
MEDICARE Part D
Compliance Regulations
Assault
Medically needy
29. Poisoning was due to: Accidental overdose; Wrong substance taken; Accidents in use of drugs and biologicals; External causes of poisonings classifiable to 980-989 Therapeutic Use: instances when a correct substance properly taken is the cause of adve
Accident
The Current Procedural Terminology (CPT)
upper appendicular skeleton
Full ROM
30. 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.
Carcinoma (Ca) in situ
Modifiers
-51 - Multiple Procedures
nonessential modifiers
31. The reason the patient came to see the physician.
Greenstick
Deductible
Chief complaint (CC)
Medigap (Medicare Supplemental Insurance)
32. The plan of the parent whose birthday falls earlier in the year (month and day - not year) is primary to that whose birthday falls later in the year. If both parents have the same birthday - then the plan of the parent who has had the longest coverag
Full ROM
Ischium
Birthday rule
phalanges (phalanx.s)
33. Pre-determined set of benefits covered under one set annual fee.
Pre-paid Health Plan
Long bones
Advance Beneficiary Notice
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
34.
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Past - family and social history (PFSH)
There are two types of sweat glands
35. The reason the patient came to see the physician.
Chief complaint (CC)
Peer Review Organization (PRO)
Category II Codes CPT
Fee-for-Service
36. 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
Category III Codes CPT
MEDICARE Part B
Retention of Medical Records
Category I Codes CPT
37. A fracture of the epiphyseal plate in children.
Carpals
Salter-Harris
Health Maintenance Organization (HMO)
itemized statement
38. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.
Subcategories
appendicular skeleton .
Undetermined
Pre-certification
39. Represent services and procedures widely used by many health care professionals in clinical practice in multiple locations and have been approved by the FDA.
Sesamoid bones
co-payment
Benign
Category I Codes CPT
40. Cheekbone
Non-covered benefit
Electronic Claim
Point-of-Service plan (POS)
Zygoma
41. the bone is broken and the ends are driven into each other.
Coinsurance
Impacted
Capitated Rates
Mandible
42. The physician must obtain this number in order to practice within a state.
Categorically needy -MEDICAID
State License Number
Physician
Workers Compensation
43. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
Primary malignancy
Sebaceous glands
There are two types of sweat glands
Alopecia
44. Consists of the skull - rib cage - and spine
MEDICARE Part D
Inferior nasal conchae
axial skeleton
State License Number
45. 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'.
Health Care Financing Administration Common Procedure Coding System
Flat bones
Pre-authorization
Sesamoid bones
46. 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
State License Number
Clearinghouse
Carpals
Sebaceous glands
47. Represent changes in the text or definition between the triangles.
Two triangular symbols (a
Medicare
Collagen
Medical Records
48. male of household is primary payer
Parietal Bones
Gender rule
Past - family and social history (PFSH)
Group Provider Number
49. Under capitation - the physician provides a full range of contracted services to covered patients for a fixed amount on a periodic basis. While guaranteed a fixed amount - the physician assumes the risk that the cost of providing the care to the pati
appendicular skeleton .
Vomer
Capitated Rates
Comminuted fracture
50. 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).
Maxilla
Sections
Group Provider Number
axial skeleton