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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. Noninvasive - non-spreading - nonmalignant
Fee-for-Service
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
The Good Samaritan Act
Benign
2. Further classified as to primary - secondary - or carcinoma in situ.
Malignant
Alopecia
Capitated Rates
A plus sign (+)
3. 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
Suicide Attempt
The St. Anthony Relative Value for Physicians (RVP)
Reasons for Documentation
Nonparticipating physician
4. 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
Colles
Established Patient
Flat bones
upper appendicular skeleton
5. The bone is broken and pierces an internal organ
appendicular skeleton .
Pubic bone
Complicated
Two triangular symbols (a
6. 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'.
Disability insurance
-51 - Multiple Procedures
Pre-authorization
Clearinghouse
7. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Liability insurance
Macule
TRICARE
Chief complaint
8. provides a five-digit code which gives the highest specificity of description to a condition. Use of it is mandatory if it is available. A code not reported to the full number of digits required is invalid. e.g. 240.01 Toxic diffuse goiter with thyr
Sub classification
Spinal/Vertebral Column
Capitated Rates
-26 - Professional Component
9. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
Primary malignancy
-99 - Multiple Modifiers
A plus sign (+)
Comminuted fracture
10. Are wrist bones. There are 2 rows of four bones in the wrist. The metacarpals are the five radiating bones in the fingers. These are the bones in the palm of the hand.
axial skeleton
Carpals
Unlisted Procedures Procedures
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
11. The CPT Index is arranged in alphabetical order by main terms which are further divided by subterms. There are five location methods: 1. Service or Procedure 2. Anatomic site 3. Condition or Disease 4. Synonym/Eponym 5. Abbreviation
sebaceous(oil) glands and the suddoriferous (sweat) glands
Location Methods
appendicular skeleton .
Participating physician
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.
Vesicle
Accept assignment
Retention of Medical Records
Personal Insurance
13. 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
Multigravida
-50 - Bilateral Procedure
Musculoskeletal System
MEDICAID COVERAGE
14. There are also terms indented two spaces to the right below the main term called subterms. These subterms are because they have bearing in the selection of the right code. Everything in the Index is listed by condition - that is - diagnosis - signs -
The St. Anthony Relative Value for Physicians (RVP)
Inpatient
essential modifiers
Melanin
15. 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
ulna
There are two types of sweat glands
The Current Procedural Terminology (CPT)
Temporal Bone
16. Any fracture occurring spontaneously as a result of disease.
Pathologic
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Participating physician
Gangrene
17. Contains complete - necessary information - but is incorrect or illogical in some way.
Group practice
Medical necessity
Pre-certification
Invalid claim
18. Is a policy that covers losses to a third party caused by the insured - by an object owned by the insured - or on premises owned by the insured. Liability insurance claims are made to cover the cost of medical care for traumatic injuries - lost wages
Radius
Liability insurance
Abuse
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
19. 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.
The St. Anthony Relative Value for Physicians (RVP)
Mutually Exclusive Edits
Unique Provider Identification Number (UPIN)
-26 - Professional Component
20. This is the index for the E codes.It classifies - in alphabetical order - environmental events and other conditions as the cause of injury and other adverse effects.
HCPCS Level I codes
Section 3 Index to External Causes of Injury (E codes)
Advance Beneficiary Notice
Medigap (Medicare Supplemental Insurance)
21. Forms the anterior part of the skull and the forehead
appendicular skeleton .
Mandible
Neoplasm Table
Frontal Bone
22. Are supplementary classification codes used to describe the reason or external cause of injury - poisoning and other adverse effects. These codes can be found in both Volumes I and II. E codes are used to classify environmental events - circumstances
Primary malignancy
Medigap (Medicare Supplemental Insurance)
-50 - Bilateral Procedure
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
23. Eccrine sweat glands are the most common and the apocrine sweat glands that secrete an odorless sweat.
There are two types of sweat glands
The Good Samaritan Act
Zygoma
Pubic bone
24. 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
Uncertain behavior
Accident
Group Provider Number
Unspecified (hypertension)
25. Any fracture occurring spontaneously as a result of disease.
Patient Confidentiality
Unlisted Procedures Procedures
Pathologic
Performing Provider Identification Number (PPIN)
26. Represents a new procedure or service code added since the previous edition of the manual.
Modifiers
Inpatient
phalanges (phalanx.s)
bullet (a
27. Make up part of the interior of the nose.
MEDICARE Part B
Complicated
Inferior nasal conchae
Two triangular symbols (a
28. Represent services and procedures widely used by many health care professionals in clinical practice in multiple locations and have been approved by the FDA.
Category I Codes CPT
sebaceous(oil) glands and the suddoriferous (sweat) glands
Group Insurance
Temporal Bone
29. open sore on the skin or mucous
Ulcermembranes
Consultation
Secondary malignancy
Salter-Harris
30. 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.
Unspecified (hypertension)
-32 - Mandated Services
New Patient
The Universal Claim Form
31. The musculoskeletal system includes the bones - muscles - and joints The musculoskeletal system acts as a framework for the organs - protects many of those organs - and also provides the organism the ability to move..
Limited ROM
Musculoskeletal System
Civil Monetary Penalties Law (CMPL)
Sections
32. 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.
Modifiers
There are three layers to the skin
encounter form
Relative Value Payment Schedules Method
33. 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.
Melanin
Advance Beneficiary Notice
Fiscal Intermediary
Category II Codes CPT
34. 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
Civil Monetary Penalties Law (CMPL)
Fee Schedule
Preferred Provider Organization (PPO)
35. 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
Sebaceous glands
Blue Cross/Blue Shield Plans
Pre-determination
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
36. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Social Security Number
Mutually Exclusive Edits
-99 - Multiple Modifiers
Inpatient
37. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body
Radius
Long bones
Preferred Provider Organization (PPO)
Secondary malignancy
38. This is the inventory of the constitutional symptoms regarding the various body systems.
Health Insurance Portability and Accountability Act (HIPAA)
Gangrene
Review of Systems (ROS)
Lipocyte
39. 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.
Group Provider Number
Liability insurance
Vomer
triangle (a
40. 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
Categories
Birthday rule
History of present illness (HPI)
Employer Identification Number (EIN)
41. forms the back of the skull. There is a large hole at the ventral surface in this bone - called the foramen magnum - which allows the brain communication with the spinal cord
Categorically needy -MEDICAID
Carpals
Occipital Bone
Medical necessity
42. A pregnant woman who has had at least one previous pregnancy.
Albino
Multigravida
HCPCS Level I codes
Electronic Claim
43. solid - round or oval elevated lesion more than 1 cm in diameter
Frontal Bone
Gender rule
Musculoskeletal System
Nodule
44. Number assigned to the physician by Medicare program.
Benign (hypertension)
Unique Provider Identification Number (UPIN)
-99 - Multiple Modifiers
Employer Identification Number (EIN)
45. Are wrist bones. There are 2 rows of four bones in the wrist. The metacarpals are the five radiating bones in the fingers. These are the bones in the palm of the hand.
Invalid claim
Carpals
Carcinoma (Ca) in situ
Nonparticipating physician
46. are small with irregular shapes. They are found in the wrist and ankle.
Clean claim
Inferior nasal conchae
Provider Identification Number (PIN)
Short bones
47. most synarthroses are immovable joints held together by fibrous tissue.
Capitated Rates
No ROM
Radius
phalanges (phalanx.s)
48. forms the two lower sides of the cranium.
Workers Compensation
Review of Systems (ROS)
Temporal Bone
phalanges (phalanx.s)
49. Numbers 1-7 - attach directly to the sternum in the front of the body.
Collagen
The Integumentary System
true ribs
Sesamoid bones
50. Number assigned by the insurance company to a physician who renders services to patients.
Multigravida
-50 - Bilateral Procedure
Colles
Provider Identification Number (PIN)