SUBJECTS
|
BROWSE
|
CAREER CENTER
|
POPULAR
|
JOIN
|
LOGIN
Business Skills
|
Soft Skills
|
Basic Literacy
|
Certifications
About
|
Help
|
Privacy
|
Terms
|
Email
Search
Test your basic knowledge |
Medical Billing And Coding Vocab
Start Test
Study First
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. 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
TRICARE PLANS
Secondary malignancy
Section 3 Index to External Causes of Injury (E codes)
MEDICARE Part B
2. 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
Civil Monetary Penalties Law (CMPL)
Categorically needy -MEDICAID
Review of Systems (ROS)
Paper Claim
3. Are composed of three-digit codes representing a single disease or condition.
The Current Procedural Terminology (CPT)
Categories
phalanges (phalanx.s)
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
4. 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
Sesamoid bones
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Pre-certification
The Integumentary System
5. A pregnant woman who has had at least one previous pregnancy.
The Good Samaritan Act
Employer Liability
Category II Codes CPT
Multigravida
6. 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
Greenstick
Medicare Claim Status
Vesicle
Occipital Bone
7. 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
Salter-Harris
Categorically needy -MEDICAID
upper appendicular skeleton
Hairline
8. '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
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Accident
axial skeleton
Employee Liability
9. Numbers 1-7 - attach directly to the sternum in the front of the body.
triangle (a
true ribs
bullet (a
Primary malignancy
10. A medical record is documentation on the patient's social and medical history - family history - physical examination findings - progress notes - radiology and lab results - consultation reports and correspondence to patient.
Location Methods
There are two types of sweat glands
There are two types of sweat glands
Medical Records
11. 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
Sections
Fee-for-Service
Outpatient
Benign
12. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
Medically needy
Eligibility
Group Insurance
essential modifiers
13. 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.
Warning
: Invalid argument supplied for foreach() in
/var/www/html/basicversity.com/show_quiz.php
on line
183
14. 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
Point-of-Service plan (POS)
Neoplasm Table
Preferred Provider plan
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
15. 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
The St. Anthony Relative Value for Physicians (RVP)
Medically needy
Pathologic
Reasons for Documentation
16. The break of the distal end of the radius at the epiphysis often occurs when the patient has attempted to break his or her fall.
False Claims Act (FCA)
Malignant
Colles
Past - family and social history (PFSH)
17. 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
The Patient Care Partnership (Patient's Bill of Rights)
ligaments
No ROM
Reasons for Documentation
18. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
Fiscal Intermediary
Rib Cage
Past - family and social history (PFSH)
Melanin
19. Deficient in pigment (melanin)
Medicare
Albino
Benign
Subcategories
20. is defined as one who has not received any medical services within the last three years.
Malignant
Medicaid
New Patient
Fiscal Intermediary
21. These parenthetic terms are called because their presence or absence does not have an effect on the selection of the code listed for the main term.
CPT SECTIONS.
nonessential modifiers
Compliance Regulations
Medicaid
22. This modifier is used to indicate that the procedure or service provided during the postoperative period was not associated with the initial procedure. Payment for the full fee of the subsequent procedure is requested and a new global period starts.
Medical necessity
Subcategories
Vomer
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
23. Numbers 1-7 - attach directly to the sternum in the front of the body.
Medicaid
true ribs
Contracted Rates with MCOs
Contracted Rates with MCOs
24. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
Unlisted Procedures Procedures
Rib Cage
Unspecified (hypertension)
Nodule
25. Is one who has no contract with the health insurance plan.
Evaluation and Management Review
The Current Procedural Terminology (CPT)
Polyp
Nonparticipating physician
26. 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
Medicare Claim Status
Workers Compensation
-99 - Multiple Modifiers
Provider Identification Number (PIN)
27. Is a working diagnosis which is not yet established.
Liability insurance
Disability insurance
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Qualified diagnosis
28. 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
upper appendicular skeleton
Carcinoma (Ca) in situ
The Universal Claim Form
Abuse
29. male of household is primary payer
Non-covered benefit
Reasons for Documentation
Gender rule
Past - family and social history (PFSH)
30. Is when two insurance companies work together to coordinate payment of the benefits.
Short bones
Preferred Provider Organization (PPO)
Coordination of Benefits (COB)
Liability insurance
31. is basically the same as HMO in the sense that the health care provider enters into contract with the MCOs to render services to the beneficiaries. However - PPO's charge a higher premium than HMO's in exchange for more flexibility and more options
MEDICAID COVERAGE
Electronic Claim
Preferred Provider Organization (PPO)
Employer Identification Number (EIN)
32. is one who has not received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years.
Temporal Bone
New patient
Section 3 Index to External Causes of Injury (E codes)
Medical necessity
33. represents Exemption from the use of modifier -51
Clearinghouse
circle with a line through it)
-26 - Professional Component
Dirty claim
34. 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
No ROM
Social Security Number
Medicare
35. 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....
The St. Anthony Relative Value for Physicians (RVP)
State License Number
Personal Insurance
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
36. 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.
Maxilla
Reasons for Documentation
Established Patient
TRICARE PLANS
37. 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
Health Care Financing Administration Common Procedure Coding System
Mutually Exclusive Edits
Clearinghouse
Carcinoma (Ca) in situ
38. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
Polyp
Assault
Group Provider Number
The Good Samaritan Act
39. This is not specified as benign or malignant in the diagnosis or medical record.
Blue Cross/Blue Shield Plans
ulna
Unspecified (hypertension)
Lacrimal bones
40. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Unspecified (hypertension)
Coding
Invalid claim
Eligibility
41. 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
Performing Provider Identification Number (PPIN)
Radius
stand-alone codes
Past - family and social history (PFSH)
42. Indicates add-on codes
A plus sign (+)
sebaceous(oil) glands and the suddoriferous (sweat) glands
stand-alone codes
TRICARE PLANS
43. Is a managed care plan that gives beneficiaries the option whom to see for services. If the beneficiary goes to see a physician within the network - s/he will receive benefits similar to an HMO. But if the beneficiary chooses to see a physician from
Mandible
Medical Records
Point-of-Service plan (POS)
New patient
44. 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
Full ROM
Carpals
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
MEDICAID COVERAGE
45. 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.
phalanges (phalanx.s)
Pubic bone
Review of Systems (ROS)
Location Methods
46. Is a service performed by a physician whose opinion or advice is requested by another physician in the evaluation or treatment of a patient's illness or suspected problem. The consultant does not assume responsibility for the patient's care and must
Compliance Regulations
Multigravida
Greenstick
Consultation
47. 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
Non-covered benefit
Categorically needy -MEDICAID
Compliance Regulations
48. is defined as one who has not received any medical services within the last three years.
Performing Provider Identification Number (PPIN)
New Patient
Radius
Fee Schedule
49. Is when two insurance companies work together to coordinate payment of the benefits.
-32 - Mandated Services
Coordination of Benefits (COB)
Qualified diagnosis
Coinsurance
50. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
Employee Liability
Multigravida
Review of Systems (ROS)
Flat bones