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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
.
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. Small collection of clear fluid;blister
Compression fracture
Chief complaint
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Vesicle
2. 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..
Workers Compensation
Musculoskeletal System
Tabular List (Volume 1)...
History of present illness (HPI)
3. 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
Medical necessity
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Preferred Provider Organization (PPO)
Accident
4. death of tissue associated with loss of blood supply
lunula
Modifiers
Contracted Rates with MCOs
Gangrene
5. 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
Health Care Financing Administration Common Procedure Coding System
Section 3 Index to External Causes of Injury (E codes)
The Integumentary System
-50 - Bilateral Procedure
6. 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.
Uncertain behavior
Hairline
Section 3 Index to External Causes of Injury (E codes)
Social Security Number
7. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.
Capitated Rates
Greenstick
Chief complaint (CC)
Occipital Bone
8. Eccrine sweat glands are the most common and the apocrine sweat glands that secrete an odorless sweat.
Compliance Regulations
There are two types of sweat glands
stand-alone codes
Advance Beneficiary Notice
9. 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
Exclusions and Limitations
Palatine bones
Pre-paid Health Plan
Patient Confidentiality
10. 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
Zygoma
Hairline
Nonparticipating physician
11. This is located in the Index under the main term 'Neoplasm' and is organized by anatomic site. Each site has six columns with six possible codes determined by whether the neoplasm is malignant - benign - of uncertain behavior - or of unspecified natu
Neoplasm Table
CPT SECTIONS.
Spinal/Vertebral Column
Lipocyte
12. Indicates add-on codes
A plus sign (+)
Invalid claim
Clean claim
Dirty claim
13. Contains complete - necessary information - but is incorrect or illogical in some way.
Full ROM
Invalid claim
Medigap (Medicare Supplemental Insurance)
Abuse
14. 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
Macule
Hypertension Table
Established Patient
Group Insurance
15. 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
Employer Liability
co-payment
Subcategories
MEDICAID COVERAGE
16. 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.
Sesamoid bones
Pre-certification
HCPCS Level II codes (National Codes)
Fee-for-Service
17. A physician has a separate PPIN for each group office/clinic in which he or she practices. In the Medicare program - in addition to a group number - each member of a group is issued an 8-character performing provider identification number.
Ischium
triangle (a
Performing Provider Identification Number (PPIN)
Location Methods
18. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
Alphabetic Index (Volume 2)
TRICARE
Suicide Attempt
Primary malignancy
19. '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
Participating physician
Employee Liability
Unique Provider Identification Number (UPIN)
Radius
20. 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.
Category III Codes CPT
encounter form
Pathologic
Wheal
21. HCPCS Reference Manual The CMS assigns a standard unique identifier known as the National Provider Identifier (NPI) The CMS also developed a two-part coding system called the Healthcare Common Procedure Coding System ( HCPCS ) which is a collection o
Pubic bone
Provider Identification Number (PIN)
Health Care Financing Administration Common Procedure Coding System
Albino
22. Indicates add-on codes
Personal Insurance
A plus sign (+)
Established patient
Employer Identification Number (EIN)
23. Benign growth extending from the surface of the mucous membrane
Polyp
Benign (hypertension)
Group practice
Coordination of Benefits (COB)
24. 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.
Commercial Carriers
Advance Beneficiary Notice
Sphenoid Bones
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
25. The bone is broken and pierces an internal organ
Electronic Claim
The Integumentary System
Deductible
Complicated
26. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
Medigap (Medicare Supplemental Insurance)
Musculoskeletal System
Medically needy
Surgical Package
27. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Birthday rule
Retention of Medical Records
History of present illness (HPI)
Unspecified nature
28. A pregnant woman who has had at least one previous pregnancy.
Multigravida
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Flat bones
Workers Compensation
29. This consists of the patient's personal experiences with illnesses - surgeries and injuries. It also contains information of illnesses predominant in the family. It contains the patient's educational background - occupation - marital status - and oth
axial skeleton
Primary malignancy
The Patient Care Partnership (Patient's Bill of Rights)
Past - family and social history (PFSH)
30. Includes - but is not limited to - physician assistant - certified nurse-midwife - qualified psychologist - nurse practitioner - clinical social worker - physical therapist - occupational therapist - respiratory therapist - certified registered nurse
Health practitioner
Inpatient
Suicide Attempt
MEDICARE Part B
31. Is when two insurance companies work together to coordinate payment of the benefits.
Multigravida
Coordination of Benefits (COB)
New patient
encounter form
32. Unlike the RBRVS - the RVP has no geographic adjustment factor or individual RVU component to calculate. However - for each category of procedures - a separate conversion factor must be developed....
true ribs
The St. Anthony Relative Value for Physicians (RVP)
Coding
Category I Codes CPT
33. 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
Greenstick
Unique Provider Identification Number (UPIN)
Disability insurance
The St. Anthony Relative Value for Physicians (RVP)
34. numbers 8-10 - are attached to the sternum by cartilage
False ribs
nonessential modifiers
Benign
premium
35. The cuticle at the lower part of the nail and this is sometimes referred to as the
TRICARE PLANS
Sub classification
eponychium
Fiscal Intermediary
36. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the
Indemnity Insurance
Workers Compensation
Frontal Bone
MEDICARE Part A
37. Also called 'global surgery' - includes a variety of services rendered by a surgeon which includes the following: Surgical procedure performed Local infiltration - metacarpal/metatarsal/digital block - or topical anesthesia Preoperative E/M services
Wheal
Medically needy
essential modifiers
Surgical Package
38. 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
Ischium
Nonparticipating physician
Chapters
Blue Cross/Blue Shield Plans
39. 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.
TRICARE
Preferred Provider plan
Fee-for-Service
Rib Cage
40. Lower portion of the pelvic bone
Medicare
Ischium
premium
Relative Value Payment Schedules Method
41. 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
Review of Systems (ROS)
eponychium
premium
Fee-for-Service
42. male of household is primary payer
Gender rule
Unspecified (hypertension)
New patient
Retention of Medical Records
43. This is not specified as benign or malignant in the diagnosis or medical record.
ulna
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
New patient
Unspecified (hypertension)
44. Is a group of two or more physicians and non-physician practitioners legally organized in a partnership - professional corporation - foundation - not-for-profit corporation - faculty practice plan - or similar association.
Section 3 Index to External Causes of Injury (E codes)
Group practice
Gender rule
Provider Identification Number (PIN)
45. Is an electronic or paper-based report of payment sent by the payer to the provider.
Remittance Advice
Vomer
Impacted
Sesamoid bones
46. 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
Group practice
Fee-for-Service
Medical Records
Frontal Bone
47. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
MEDICARE Part A
Mutually Exclusive Edits
Melanin
Deductible
48. The moon like white area at the base of the nail.
Parietal Bones
Location Methods
lunula
Health Maintenance Organization (HMO)
49. Represents a new procedure or service code added since the previous edition of the manual.
Civil Monetary Penalties Law (CMPL)
bullet (a
Add-on codes
Medicare
50. 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
Secondary malignancy
The St. Anthony Relative Value for Physicians (RVP)
Evaluation and Management Review
Patient Confidentiality