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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.
If you are not ready to take this test, you can
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. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
Lipocyte
Impetigo
Provider Identification Number (PIN)
Melanin
2. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
Add-on codes
Health Insurance Portability and Accountability Act (HIPAA)
Pre-certification
true ribs
3. Is when two insurance companies work together to coordinate payment of the benefits.
nonessential modifiers
Pubic bone
Coordination of Benefits (COB)
Impacted
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
Pre-certification
Fiscal Intermediary
Fee Schedule
Musculoskeletal System
5. Discolored - flat lesion (freckles - tattoo marks)
Fraud
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Macule
Social Security Number
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
Colles
Unique Provider Identification Number (UPIN)
Accident
Tabular List (Volume 1)...
7. This is attached to the code of the E/M service provided to a patient during the postoperative period to indicate that that service is not part of the postoperative care which is usually part of a package of services of the surgery performed. Major s
Medigap (Medicare Supplemental Insurance)
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Long bones
Personal Insurance
8. Indicates add-on codes
A plus sign (+)
Humerus
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Fee Schedule
9. This is attached to the code of the E/M service provided to a patient during the postoperative period to indicate that that service is not part of the postoperative care which is usually part of a package of services of the surgery performed. Major s
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Comminuted fracture
Humerus
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
10. Superior and widest bone
Occipital Bone
Pelvis
Chief complaint (CC)
Health Care Financing Administration Common Procedure Coding System
11. Any fracture occurring spontaneously as a result of disease.
Temporal Bone
Pathologic
Malignant
Gangrene
12. Bone that forms posterior/inferior part of the nasal septal wall between the nostrils.
The Integumentary System
Compliance Regulations
Chief complaint
Vomer
13. Is the federal government's health insurance program created by the Social Security Act of 1965 titled 'Health Insurance for the Aged and Disabled'. It is administered by the Centers for Medicare and Medicaid Services (CMS) - formerly known as Health
Limited ROM
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Multigravida
Medicare
14. Typically not used on the claim form unless the provider does not have an EIN.
Chief complaint (CC)
-32 - Mandated Services
eponychium
Social Security Number
15. Is a document provided to a Medicare beneficiary by a provider prior to service being rendered letting the beneficiary know of his/her responsibility to pay if Medicare denies the claim.
Advance Beneficiary Notice
Gender rule
Fee Schedule
Inpatient
16. 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
Birthday rule
Fee Schedule
Ethmoid Bone
Frontal Bone
17. 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)
Wheal
Unspecified nature
circle with a line through it)
co-payment
18. Is the lower medial arm bone.
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
ulna
Nonparticipating physician
Rejected claim
19. consists of 17 chapters based on either body system or cause or type of disease. The codes range from 001-999.
Ulcermembranes
Tabular List (Volume 1)...
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Pre-certification
20. This modifier is used when the same procedure is performed on a mirror-image part of the body..
Vomer
Rejected claim
Indemnity Insurance
-50 - Bilateral Procedure
21. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.
Peer Review Organization (PRO)
Wheal
Two triangular symbols (a
Gender rule
22. All patients have a right to privacy and all information should remain privileged. Discuss patient information only with the patient's physician or office personnel that need certain information to do their job. Obtain a signed consent form to releas
Palatine bones
Patient Confidentiality
Social Security Number
Nodule
23. forms the roof of the nasal cavity.
Medicaid
nonessential modifiers
Ethmoid Bone
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
24. 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
Birthday rule
Location Methods
Past - family and social history (PFSH)
25. Lower portion of the pelvic bone
Pelvis
Paper Claim
Ischium
Lacrimal bones
26. Is the lateral lower arm bone (in line with the thumb).
Health practitioner
Categories
Coinsurance
Radius
27. paired bones at the corner of each eye that cradle the tear ducts.
Hypertension Table
Lacrimal bones
Past - family and social history (PFSH)
Subcategories
28. 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).
stand-alone codes
Employer Identification Number (EIN)
Chapters
bullet (a
29. 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
Ethmoid Bone
Gender rule
Workers Compensation
Vomer
30. the bone is crushed and or shattered.
Dirty claim
Group Provider Number
Comminuted fracture
Explanation of Benefits (EOB)
31. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients
Hairline
Rib Cage
-26 - Professional Component
HCPCS Level I codes
32. Produce secretions that allow the body to be moisturized or cooled.
sebaceous(oil) glands and the suddoriferous (sweat) glands
The Current Procedural Terminology (CPT)
Carcinoma (Ca) in situ
Social Security Number
33. Are small - rounded bones that resemble a sesame seed. They are found near joints and increase the efficiency of muscles near a joint. An example of sesamoid bone is the knee cap.
TRICARE
Inferior nasal conchae
Sesamoid bones
Health practitioner
34. Lower portion of the pelvic bone
Ischium
Preferred Provider plan
Albino
Sphenoid Bones
35. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Pre-certification
Unspecified nature
Collagen
Fiscal Intermediary
36. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
Pelvis
Employee Liability
Deductible
Parietal Bones
37. 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
Primary malignancy
Occipital Bone
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Frontal Bone
38. Physicians agree to provide services at a discount of their usual fee in return for a pool of existing patients.
Carcinoma (Ca) in situ
Qualified diagnosis
Contracted Rates with MCOs
TRICARE PLANS
39. 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.
Commercial Carriers
Palatine bones
-26 - Professional Component
Established patient
40. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
Full ROM
Occipital Bone
Lipocyte
Participating physician
41. male of household is primary payer
Wheal
Coinsurance
Pubic bone
Gender rule
42. Small collection of clear fluid;blister
Compression fracture
true ribs
Established patient
Vesicle
43. Benign growth extending from the surface of the mucous membrane
Paper Claim
TRICARE
ligaments
Polyp
44. requires investigation and needs further clarification.
Explanation of Benefits (EOB)
Complicated
sebaceous(oil) glands and the suddoriferous (sweat) glands
Rejected claim
45. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
encounter form
Flat bones
Birthday rule
Mandible
46. Are supplemental codes used for performance measurements. Although these codes are intended to facilitate data collection about the quality of care - their use is optional. Category II codes are published twice a year: January 1st and July 1st.
Pre-determination
Category II Codes CPT
Remittance Advice
TRICARE PLANS
47. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
Primary malignancy
Workers Compensation
Macule
Patient Confidentiality
48. The physician must obtain this number in order to practice within a state.
Group Insurance
Unspecified (hypertension)
State License Number
upper appendicular skeleton
49. Are conditions - situations - and services not covered by the insurance carrier.
Exclusions and Limitations
Tabular List (Volume 1)...
Secondary malignancy
Non-covered benefit
50. 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
Group Insurance
Location Methods
Clean claim
Alphabetic Index (Volume 2)