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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. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.
Wheal
premium
Fraud
Limited ROM
2. Upper jaw bone
TRICARE
Gender rule
Maxilla
Sub classification
3. 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
Health practitioner
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Dirty claim
4. This modifier is used to indicate that the procedure was done by an outside laboratory and not by the reporting facility or clinic.
Location Methods
Group practice
Indemnity Insurance
-90 - Reference (Outside) Laboratory
5. 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
Compliance Regulations
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
MEDICARE Part A
Location Methods
6. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
There are two types of sweat glands
Primary malignancy
Musculoskeletal System
Medical necessity
7. 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.
Established Patient
Coinsurance
Surgical Package
Radius
8. Are located in the dermal layer of the skin over the entire body - except for the palms of the hands and soles of the feet. The sebaceous glands secrete an oily substance called sebum. Sebum contains lipids that help lubricate the skin and minimize w
Outpatient
Pre-determination
Sebaceous glands
State License Number
9. 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
Frontal Bone
Palatine bones
The Current Procedural Terminology (CPT)
Coding
10. Groove or crack like sore
Abuse
Hypertension Table
Fissure
Carpals
11. 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
Multigravida
Sesamoid bones
12. Benign growth extending from the surface of the mucous membrane
Provider Identification Number (PIN)
Pre-paid Health Plan
Established patient
Polyp
13. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
eponychium
Sub classification
New patient
Rib Cage
14. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the
MEDICARE Part A
Remittance Advice
upper appendicular skeleton
Macule
15. 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.
Medicaid
MEDICAID COVERAGE
Assault
Two triangular symbols (a
16. Is a patient who receives treatment in any of the following settings: physician's office ;hospital clinic - emergency department - hospital same-day surgery unit - ambulatory surgical center ( patient is released within 23 hours) ;hospital admission
Group practice
Outpatient
Health practitioner
encounter form
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.
Performing Provider Identification Number (PPIN)
Gangrene
Greenstick
Electronic Claim
18. Discolored - flat lesion (freckles - tattoo marks)
Pre-paid Health Plan
Musculoskeletal System
Deductible
Macule
19. is referred to as Supplementary Medical Insurance (SMI). This coverage is a supplement to Part A - which covers medical expenses - clinical laboratory services - home health care - outpatient hospital treatment - blood - and ambulatory surgical serv
Unique Provider Identification Number (UPIN)
There are two types of sweat glands
The Good Samaritan Act
MEDICARE Part B
20. 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
Fee Schedule
Spinal/Vertebral Column
Malignant
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
21. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
Reasons for Documentation
Unspecified (hypertension)
Impetigo
Keratin
22. 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
Social Security Number
Group Insurance
Explanation of Benefits (EOB)
Assault
23. solid - round or oval elevated lesion more than 1 cm in diameter
Fiscal Intermediary
Vesicle
Unlisted Procedures Procedures
Nodule
24. Groove or crack like sore
eponychium
Preferred Provider Organization (PPO)
Melanin
Fissure
25. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body
Inferior nasal conchae
Commercial Carriers
Secondary malignancy
co-payment
26. 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.
27.
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
There are three layers to the skin
Nodule
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
28. Noninvasive - non-spreading - nonmalignant
Wheal
Radius
Benign
Established Patient
29. Is to determine the patient's benefits and the maximum dollar amount that the insurance company will pay. Often the first step of the insurance verification process - it is completed prior to the first visit.
Assault
Nonparticipating physician
Pre-determination
Accident
30. Typically not used on the claim form unless the provider does not have an EIN.
Eligibility
Employee Liability
essential modifiers
Social Security Number
31. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Benign (hypertension)
Limited ROM
sprain
Employer Identification Number (EIN)
32. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
The Good Samaritan Act
Long bones
Primary malignancy
Indemnity Insurance
33. represents Exemption from the use of modifier -51
circle with a line through it)
Humerus
The St. Anthony Relative Value for Physicians (RVP)
Group Provider Number
34. Is one who has no contract with the health insurance plan.
Categorically needy -MEDICAID
Nonparticipating physician
Health Maintenance Organization (HMO)
Undetermined
35. The main term in the index may by followed by terms within parenthesis.
Alphabetic Index (Volume 2)
Impetigo
Remittance Advice
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
36. The reason the patient came to see the physician.
Flat bones
Consultation
Chief complaint (CC)
Unspecified (hypertension)
37. 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.
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Fraud
Assault
Provider Identification Number (PIN)
38. Superior and widest bone
Pelvis
Flat bones
circle with a line through it)
Suicide Attempt
39. 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
Chief complaint
Unique Provider Identification Number (UPIN)
Health practitioner
40. 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
Relative Value Payment Schedules Method
False Claims Act (FCA)
Indemnity Insurance
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
41. Was created to provide medical benefits to spouses and children of veterans with total - permanent service related disabilities or for surviving spouses and children of a veteran who died as a result of service-related disability. It is a service ben
lunula
Employee Liability
Accept assignment
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
42. Deficient in pigment (melanin)
Non-covered benefit
Alopecia
Albino
Preferred Provider Organization (PPO)
43. 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.
Invalid claim
Employer Liability
Established Patient
Peer Review Organization (PRO)
44. A minor fracture appears as a thin line on x-ray and may not extend completely through the bone.
Multigravida
stand-alone codes
Temporal Bone
Hairline
45. requires investigation and needs further clarification.
Employer Liability
Rejected claim
Mandible
Vomer
46. 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
Group practice
Short bones
Liability insurance
Reasons for Documentation
47. Various terms are used to describe the state of submitted forms. The following are some of the terms that are typically used by insurance carriers.
Colles
Medicare Claim Status
Hairline
Health Care Financing Administration Common Procedure Coding System
48. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.
Colles
Established patient
Group practice
Peer Review Organization (PRO)
49. 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
Disability insurance
Blue Cross/Blue Shield Plans
-51 - Multiple Procedures
Inpatient
50. 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.
Collagen
Vomer
There are three layers to the skin
Group Provider Number