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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.
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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. Is the cost of insurance coverage paid annually - semi-annually or monthly to keep a policy in effect.
Chapters
Frontal Bone
Collagen
premium
2. - To pay for medical services and items that Medicare does not cover and Medicare's coinsurance and deductibles - beneficiaries may purchase a supplemental insurance. Medigap is a private insurance designed to help pay for those amounts that are typ
Medigap (Medicare Supplemental Insurance)
Lacrimal bones
Multigravida
Participating physician
3. 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
Workers Compensation
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Impacted
Physician
4. anterior to the temporal bones.
Disability insurance
Two triangular symbols (a
Fraud
Sphenoid Bones
5. 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.
There are three layers to the skin
-26 - Professional Component
Collagen
Fee Schedule
6. In July 2001 - the Health Care Financing Administration (HCFA) became the Centers for Medicare & Medicaid Services (CMS) - and the universal claim form HCFA-1500 became the CMS-1500.Virtually all third-party payers will accept it - and Medicare requ
Relative Value Payment Schedules Method
Group Provider Number
The Universal Claim Form
Rejected claim
7. 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.
Pre-determination
co-payment
Suicide Attempt
Group Provider Number
8. numbers 8-10 - are attached to the sternum by cartilage
Accept assignment
False ribs
essential modifiers
Salter-Harris
9. Is an electronic or paper-based report of payment sent by the payer to the provider.
Primary malignancy
Remittance Advice
sprain
Medical necessity
10. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Peer Review Organization (PRO)
Keratin
triangle (a
11. numbers 8-10 - are attached to the sternum by cartilage
Hypertension Table
Compression fracture
False ribs
The Universal Claim Form
12. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Group Insurance
Chief complaint
Nodule
Keratin
13. are small with irregular shapes. They are found in the wrist and ankle.
Short bones
Section 3 Index to External Causes of Injury (E codes)
Benign (hypertension)
Greenstick
14. The moon like white area at the base of the nail.
HCPCS Level II codes (National Codes)
Lipocyte
lunula
Rejected claim
15. Is a fee that is charged for each procedure or service performed by the physician. This fee is obtained from a fee schedule - which is a list of charges or allowance that have accepted for specific medical services. The system in which fee schedules
Fee-for-Service
Dirty claim
Eligibility
Impetigo
16. The bone is broken and pierces an internal organ
Category III Codes CPT
Hypertension Table
Complicated
Unique Provider Identification Number (UPIN)
17. The spinal /vertebral column is divided into five regions from the neck to the tailbone. There are 26 bones in the spine and they are referred to as the vertebrae. The following list explains the bones of the spine: Cervical -Neck Bones -Thoracic -U
Spinal/Vertebral Column
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Pre-certification
Vesicle
18. 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
Alopecia
Pre-authorization
MEDICARE Part A
Medicare
19. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Add-on codes
Deductible
Nodule
20. Upper jaw bone
The Current Procedural Terminology (CPT)
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Maxilla
bullet (a
21. Mild or controlled hypertension and no damage to the vascular system or organs.
Medicaid
Medical necessity
Benign (hypertension)
Nonparticipating physician
22. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
A plus sign (+)
Clean claim
Accept assignment
Alphabetic Index (Volume 2)
23. 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
itemized statement
Clearinghouse
Sub classification
Humerus
24. Deficient in pigment (melanin)
Albino
Lacrimal bones
New Patient
Abuse
25. male of household is primary payer
nonessential modifiers
sebaceous(oil) glands and the suddoriferous (sweat) glands
Gender rule
Categories
26. 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
Complicated
Location Methods
Alopecia
TRICARE
27.
Commercial Carriers
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Malignant
Peer Review Organization (PRO)
28. 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.
Benign
sprain
Limited ROM
Medicaid
29. 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.
Palatine bones
Blue Cross/Blue Shield Plans
Established Patient
Nonparticipating physician
30. A minor fracture appears as a thin line on x-ray and may not extend completely through the bone.
Performing Provider Identification Number (PPIN)
Hairline
MEDICAID COVERAGE
Patient Confidentiality
31. death of tissue associated with loss of blood supply
Gangrene
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Accident
Sphenoid Bones
32. 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
upper appendicular skeleton
Unauthorized benefit
Chief complaint (CC)
Employer Liability
33. Prescription Drugs The Medicare Prescription Drug - Improvement - and Modernization Act enacted in December 2003 and began implementation in January 2006 where Medicare beneficiaries can enroll in the Medicare prescription drug plan. The beneficiari
Capitated Rates
essential modifiers
MEDICARE Part D
Ischium
34. 'Errors and omissions insurance' is protection against loss of monies caused by failure through error or unintentional omission on the part of the individual or service submitting the insurance claim. Some physicians' contract with a billing service
False Claims Act (FCA)
State License Number
Employee Liability
Alopecia
35. 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
ligaments
Categories
Employer Liability
Suicide Attempt
36. 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
Peer Review Organization (PRO)
Fraud
Health Care Financing Administration Common Procedure Coding System
37. 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.
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Point-of-Service plan (POS)
-32 - Mandated Services
circle with a line through it)
38. Was developed to promote the interests and well being of the patients and residents of the healthcare facility. This bill has still not become a law.
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39. The skin and its accessory organs.Integument means covering. The skin covers over an area of 22 square feet ( an average adult). It is a complex system of specialized tissues containing glands - nerves and blood vessels. The main function of the skin
The Integumentary System
Chapters
Hypertension Table
Fissure
40. 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.
Provider Identification Number (PIN)
Birthday rule
phalanges (phalanx.s)
Benign (hypertension)
41. 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
Paper Claim
TRICARE PLANS
Salter-Harris
co-payment
42. Provide a four-digit code (one digit after the decimal point) which is more specific than category code (3-digit) in terms of cause - site - or manifestation of the condition. This must be used if available. From subcategory - specificity moves to an
Subcategories
Suicide Attempt
Greenstick
Preferred Provider plan
43. paired bones at the corner of each eye that cradle the tear ducts.
Lacrimal bones
Group practice
Gender rule
Accept assignment
44. Is a working diagnosis which is not yet established.
Qualified diagnosis
Birthday rule
Consultation
Secondary malignancy
45. Is a percentage of the cost of covered services that a policyholder or a secondary insurance pays. A common payment percentage for coinsurance is 80/20 which indicates that 20% is the coinsurance for which the beneficiary or secondary insurance is re
Coinsurance
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
encounter form
Sub classification
46. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
nonessential modifiers
Carcinoma (Ca) in situ
Pelvis
A plus sign (+)
47. Represents a new procedure or service code added since the previous edition of the manual.
Coding
Occipital Bone
bullet (a
Inpatient
48. Represent changes in the text or definition between the triangles.
Health Care Financing Administration Common Procedure Coding System
Two triangular symbols (a
Evaluation and Management Review
Health practitioner
49. This modifier is used when: more than one procedure is performed during the same surgical episode; one code does not describe all of the procedures performed; and the secondary procedure is not minor or incidental to the major procedure. The followin
Primary malignancy
-51 - Multiple Procedures
Medically needy
There are three layers to the skin
50. Is the lower medial arm bone.
Health Insurance Portability and Accountability Act (HIPAA)
ulna
Qualified diagnosis
-50 - Bilateral Procedure