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Test your basic knowledge |
Medical Billing And Coding Vocab
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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. Under this schedule - a procedure's relative value is the sum total of three elements: Work: represents the amount of time - intensity of effort - and medical skill required of the physician. Overhead: practice costs related to the performing of the
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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
Carpals
Suicide Attempt
lunula
Paper Claim
3. 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..
No ROM
Musculoskeletal System
Hypertension Table
Hypertension Table
4. Consists of the skull - rib cage - and spine
Macule
axial skeleton
Suicide Attempt
New patient
5. The lower anterior part of the bone
Primary malignancy
Nodule
Pubic bone
-99 - Multiple Modifiers
6. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Personal Insurance
Pre-certification
Group Insurance
Accept assignment
7. Contains complete - necessary information - but is incorrect or illogical in some way.
Blue Cross/Blue Shield Plans
Invalid claim
History of present illness (HPI)
Modifiers
8. 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
Benign
The Universal Claim Form
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Ischium
9. Under this schedule - a procedure's relative value is the sum total of three elements: Work: represents the amount of time - intensity of effort - and medical skill required of the physician. Overhead: practice costs related to the performing of the
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10. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
Long bones
Modifiers
Wheal
Greenstick
11. The main term in the index may by followed by terms within parenthesis.
Alphabetic Index (Volume 2)
Electronic Claim
Pubic bone
Indemnity Insurance
12. Are composed of three-digit codes representing a single disease or condition.
Abuse
Limited ROM
Categories
Alopecia
13. Retention of medical records is governed by state and local laws and may vary from state-to-state. Most physicians are required to retain records indefinitely; deceased patient records should be kept for at least five (5) years.
Health Insurance Portability and Accountability Act (HIPAA)
circle with a line through it)
Retention of Medical Records
Categorically needy -MEDICAID
14. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Hairline
Accept assignment
Employer Identification Number (EIN)
15. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
Group Provider Number
Carcinoma (Ca) in situ
Unspecified (hypertension)
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
16. '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
Exclusions and Limitations
Alphabetic Index (Volume 2)
There are two types of sweat glands
Employee Liability
17. is defined as one who has not received any medical services within the last three years.
New Patient
Point-of-Service plan (POS)
Gangrene
Pre-determination
18. 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
sprain
ligaments
Nodule
Pubic bone
19. The epidermis - the dermis - and the subcutaneous layer. The epidermis is a thin - cellular membrane layer that contains keratin. The dermis is a dense - fibrous - connective tissue that contains collagen. The subcutaneous layer is a thicker and fatt
There are three layers to the skin
Mandible
Fee-for-Service
Subcategories
20. 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.
Ischium
The St. Anthony Relative Value for Physicians (RVP)
Undetermined
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
21. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
Parietal Bones
Indemnity Insurance
Benign (hypertension)
Malignant
22. This is an alternative to paper claims submitted to the third-party payer directly by the physician or through a clearinghouse. Electronic claims are usually paid faster than paper claims and most electronic claims software have self-editing features
Exclusions and Limitations
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
essential modifiers
Electronic Claim
23. 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.
Colles
Compression fracture
Lacrimal bones
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
24. 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
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
MEDICAID COVERAGE
Palatine bones
Secondary malignancy
25. Is a percentage of the cost of covered services that a policyholder or a secondary insurance pays. A common payment percentage for coinsurance is 80/20 which indicates that 20% is the coinsurance for which the beneficiary or secondary insurance is re
Multigravida
Palatine bones
Coinsurance
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
26. Superior and widest bone
Clearinghouse
History
Pelvis
Fee-for-Service
27. Is when two insurance companies work together to coordinate payment of the benefits.
Coordination of Benefits (COB)
Medicare
Qualified diagnosis
Malignant
28. make up part of the roof of the mouth
Wheal
Palatine bones
encounter form
Patient Confidentiality
29. are small with irregular shapes. They are found in the wrist and ankle.
Health practitioner
Performing Provider Identification Number (PPIN)
Short bones
Chief complaint (CC)
30. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
-50 - Bilateral Procedure
Alopecia
Long bones
Health Care Financing Administration Common Procedure Coding System
31. 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.
Parietal Bones
Keratin
ulna
phalanges (phalanx.s)
32. This modifier is used when: more than one procedure is performed during the same surgical episode; one code does not describe all of the procedures performed; and the secondary procedure is not minor or incidental to the major procedure. The followin
Reasons for Documentation
essential modifiers
-51 - Multiple Procedures
Non-covered benefit
33. 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.
Assault
HCPCS Level II codes (National Codes)
Medicare Claim Status
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
34. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.
Limited ROM
Invalid claim
Alphabetic Index (Volume 2)
New patient
35. Lower portion of the pelvic bone
CPT SECTIONS.
Ischium
Colles
Humerus
36. major skin pigment
Melanin
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Participating physician
Contracted Rates with MCOs
37. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
History of present illness (HPI)
Chief complaint
Uncertain behavior
Commercial Carriers
38. forms the roof of the nasal cavity.
Ethmoid Bone
Personal Insurance
Melanin
Radius
39. Are conditions - situations - and services not covered by the insurance carrier.
Tabular List (Volume 1)...
Group Insurance
Uncertain behavior
Exclusions and Limitations
40. 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
MEDICAID COVERAGE
-32 - Mandated Services
ulna
41. Number assigned by the insurance company to a physician who renders services to patients.
bullet (a
Provider Identification Number (PIN)
triangle (a
Keratin
42. 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
Point-of-Service plan (POS)
Gender rule
Spinal/Vertebral Column
43. 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.
Explanation of Benefits (EOB)
Medicaid
Clearinghouse
National Correct Coding Initiative (NCCI)
44. Indicates add-on codes
Exclusions and Limitations
Collagen
Abuse
A plus sign (+)
45. The bone is broken and pierces an internal organ
Complicated
nonessential modifiers
Uncertain behavior
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
46. Represents a new procedure or service code added since the previous edition of the manual.
bullet (a
Medicare
Consultation
Inpatient
47. The physician must obtain this number in order to practice within a state.
There are two types of sweat glands
HCPCS Level II codes (National Codes)
State License Number
MEDICARE Part D
48. Is a term used when a patient is admitted to the hospital with the expectation that the patient will stay for a period of 24 hours or more.
Inpatient
sprain
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Sphenoid Bones
49. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
sebaceous(oil) glands and the suddoriferous (sweat) glands
Impetigo
Qualified diagnosis
Hairline
50. 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.
Zygoma
Medical Records
Limited ROM
sebaceous(oil) glands and the suddoriferous (sweat) glands