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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
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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. paired bones at the corner of each eye that cradle the tear ducts.
Comminuted fracture
History of present illness (HPI)
itemized statement
Lacrimal bones
2. Groove or crack like sore
Salter-Harris
MEDICARE Part B
Fissure
Coordination of Benefits (COB)
3. Are a group of independently licensed local companies - usually nonprofit that contracts with physicians and other health entities to provide services to their insured companies and individuals. Most BC/BS plans offer HMO's - PPO's and POS plans. Blu
Lipocyte
Inferior nasal conchae
Workers Compensation
Blue Cross/Blue Shield Plans
4. Contains complete - necessary information - but is incorrect or illogical in some way.
Spinal/Vertebral Column
Outpatient
Invalid claim
Secondary malignancy
5. 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
appendicular skeleton .
Inferior nasal conchae
The Current Procedural Terminology (CPT)
Medical necessity
6. is a traumatic injury to a joint involving the soft tissue.
sprain
Nonparticipating physician
Melanin
MEDICARE Part A
7. the bone is crushed and or shattered.
Modifiers
Comminuted fracture
Humerus
Pre-paid Health Plan
8. Indicates add-on codes
Group Insurance
Lipocyte
Sesamoid bones
A plus sign (+)
9. 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
Medicare Claim Status
Subcategories
History
Group practice
10. Small collection of clear fluid;blister
Vesicle
-50 - Bilateral Procedure
Participating physician
Clean claim
11. Is the upper arm bone.
Chief complaint (CC)
Unlisted Procedures Procedures
Benign
Humerus
12. death of tissue associated with loss of blood supply
Gangrene
Preferred Provider Organization (PPO)
The Current Procedural Terminology (CPT)
Inpatient
13. Represents a change in the code description since the last edition. The change may be minor or significant and it could be an addition - deletion or revision.
triangle (a
Rib Cage
Relative Value Payment Schedules Method
New Patient
14. This is not specified as benign or malignant in the diagnosis or medical record.
Unspecified (hypertension)
Lacrimal bones
Hairline
bullet (a
15. 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.
Hairline
National Correct Coding Initiative (NCCI)
Pelvis
-32 - Mandated Services
16. 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).
Carcinoma (Ca) in situ
Chapters
Birthday rule
-90 - Reference (Outside) Laboratory
17. 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.
Short bones
Pathologic
Greenstick
itemized statement
18. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.
Sebaceous glands
Gender rule
Hypertension Table
Peer Review Organization (PRO)
19. Poisoning cannot be determined whether intentional or accidental.
Subcategories
Undetermined
Modifiers
Pre-determination
20. Describes the services billed and includes a breakdown of how the payment is determined
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Explanation of Benefits (EOB)
Category II Codes CPT
sprain
21. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.
Medically needy
encounter form
Dirty claim
MEDICARE Part C
22. Is the type of plan a patient may have where they can see providers outside their plan. The patient is responsible to pay the higher portion of the fee.
Preferred Provider plan
Short bones
Fiscal Intermediary
Albino
23. Is the type of plan a patient may have where they can see providers outside their plan. The patient is responsible to pay the higher portion of the fee.
Preferred Provider plan
Group Insurance
Indemnity Insurance
Benign
24. 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).
Liability insurance
Sections
-50 - Bilateral Procedure
Group practice
25. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Section 3 Index to External Causes of Injury (E codes)
Non-covered benefit
Coding
true ribs
26. poisoning was inflicted by another person with intent to kill or injure
Assault
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Albino
There are three layers to the skin
27. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Malignant
Accept assignment
MEDICARE Part A
Medically needy
28. .. lower jaw bone.
Mandible
Fiscal Intermediary
Coinsurance
Sub classification
29. Numbers 1-7 - attach directly to the sternum in the front of the body.
Gender rule
true ribs
Undetermined
Outpatient
30. Upper jaw bone
Reasons for Documentation
Maxilla
Medical necessity
Fraud
31. Created the Health Care Fraud and Abuse Control Program enacted to check for fraud and abuse in the Medicare and Medicaid programs - and private payers.
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Nodule
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
ulna
32. the bone is broken and the ends are driven into each other.
Impacted
upper appendicular skeleton
Retention of Medical Records
Mutually Exclusive Edits
33. Is the lateral lower arm bone (in line with the thumb).
Disability insurance
Radius
Dirty claim
Categories
34. This is not specified as benign or malignant in the diagnosis or medical record.
Unspecified (hypertension)
Qualified diagnosis
Macule
Ischium
35. Deficient in pigment (melanin)
False Claims Act (FCA)
Non-covered benefit
Vomer
Albino
36. Has all required fields accurately filled out - contains no deficiencies and passes all edits. The carrier does not require investigation outside of the carrier's operation before paying the claim.
Fiscal Intermediary
Group Provider Number
Clean claim
Albino
37. requires investigation and needs further clarification.
Wheal
Rejected claim
National Correct Coding Initiative (NCCI)
Section 3 Index to External Causes of Injury (E codes)
38. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
Health Insurance Portability and Accountability Act (HIPAA)
Hypertension Table
Hairline
Inferior nasal conchae
39. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
Occipital Bone
Liability insurance
Malignant
Unspecified (hypertension)
40. Bone that forms posterior/inferior part of the nasal septal wall between the nostrils.
Vomer
Contracted Rates with MCOs
MEDICARE Part D
Chapters
41. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
Evaluation and Management Review
The Good Samaritan Act
Medicaid
Inferior nasal conchae
42. 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.
Complicated
Comminuted fracture
Chapters
phalanges (phalanx.s)
43. 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
circle with a line through it)
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Vesicle
Chapters
44. represents Exemption from the use of modifier -51
Invalid claim
circle with a line through it)
Unauthorized benefit
Spinal/Vertebral Column
45. Has all required fields accurately filled out - contains no deficiencies and passes all edits. The carrier does not require investigation outside of the carrier's operation before paying the claim.
stand-alone codes
MEDICARE Part A
Clean claim
Fee Schedule
46. Are temporary codes for emerging technology - services and procedures. If a Category III code is available - it is reported instead of a Category I unlisted code.
HCPCS Level II codes (National Codes)
Category III Codes CPT
MEDICARE Part B
Relative Value Payment Schedules Method
47. 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.
Ulcermembranes
Health Care Financing Administration Common Procedure Coding System
Frontal Bone
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
48. 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)
The Patient Care Partnership (Patient's Bill of Rights)
Deductible
eponychium
49. 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
Pre-paid Health Plan
Patient Confidentiality
Benign
Ulcermembranes
50. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
Colles
-32 - Mandated Services
Unlisted Procedures Procedures
Health Insurance Portability and Accountability Act (HIPAA)