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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.
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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. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.
Pre-certification
Uncertain behavior
Pre-determination
HCPCS Level I codes
2. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
Salter-Harris
Employee Liability
Long bones
Established Patient
3. are small with irregular shapes. They are found in the wrist and ankle.
Spinal/Vertebral Column
Short bones
-90 - Reference (Outside) Laboratory
A plus sign (+)
4. 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
New patient
Sebaceous glands
False Claims Act (FCA)
5. poisoning was inflicted by another person with intent to kill or injure
Accident
Abuse
Assault
Salter-Harris
6. 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
Category II Codes CPT
The Current Procedural Terminology (CPT)
HCPCS Level I codes
Coding
7. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.
Greenstick
Parietal Bones
true ribs
upper appendicular skeleton
8. Federal law that prohibits submitting a fraudulent claim or making a false statement or representation in connection with a claim. It also protects and rewards persons involved in whistle-blower cases.
Indemnity Insurance
MEDICARE Part C
False Claims Act (FCA)
Inpatient
9. 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.
Accident
Section 3 Index to External Causes of Injury (E codes)
Impetigo
-50 - Bilateral Procedure
10. Forms the sides of the cranium
Parietal Bones
Fee-for-Service
itemized statement
Palatine bones
11. Forms the anterior part of the skull and the forehead
Frontal Bone
Radius
Occipital Bone
Fee-for-Service
12. This involves the use of relative value scales which assign a relative weight to individual services according to the basis for the scale. Services that are more difficult - time consuming - or resource intensive to perform typically have higher rela
Relative Value Payment Schedules Method
Physician
Two triangular symbols (a
Established Patient
13. Structural protein found in the skin and connective tissue
Secondary malignancy
Collagen
History of present illness (HPI)
Neoplasm Table
14. are composed of a group of three-digit categories representing a group of conditions or related conditions; they are divided into categories. e.g. . - Disorders of Thyroid Gland (240 - 246).
Sections
Subcategories
Fee Schedule
phalanges (phalanx.s)
15. The fractured area of bone collapses on itself.
Compression fracture
Hypertension Table
Health practitioner
Qualified diagnosis
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
Social Security Number
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Peer Review Organization (PRO)
17. Has all required fields accurately filled out - contains no deficiencies and passes all edits. The carrier does not require investigation outside of the carrier's operation before paying the claim.
Capitated Rates
Clean claim
Social Security Number
Nonparticipating physician
18. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Occipital Bone
The Universal Claim Form
Medicare
Mutually Exclusive Edits
19. 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
itemized statement
Reasons for Documentation
Occipital Bone
TRICARE PLANS
20. 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).
Past - family and social history (PFSH)
Chapters
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Eligibility
21. The main term in the index may by followed by terms within parenthesis.
Medicaid
Primary malignancy
Alphabetic Index (Volume 2)
Malignant
22. Are codes formulated thru the joint efforts of the CMS - the Health Insurance Association of America - and the Blue Cross and Blue Shield Association. Level II contains five position alpha-numeric codes for physician and non-physician services not fo
Humerus
HCPCS Level II codes (National Codes)
circle with a line through it)
The Patient Care Partnership (Patient's Bill of Rights)
23. Is defined as a doctor of medicine or osteopathy - dental medicine - dental surgery - podiatric medicine - optometry - or chiropractic medicine legally authorized to practice by the state in which he/she performs.
Health Care Financing Administration Common Procedure Coding System
Physician
CPT SECTIONS.
Impacted
24. Is defined as a doctor of medicine or osteopathy - dental medicine - dental surgery - podiatric medicine - optometry - or chiropractic medicine legally authorized to practice by the state in which he/she performs.
Comminuted fracture
Comminuted fracture
Greenstick
Physician
25. 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.
Fraud
Advance Beneficiary Notice
Abuse
Zygoma
26. Typically not used on the claim form unless the provider does not have an EIN.
Accident
Advance Beneficiary Notice
Peer Review Organization (PRO)
Social Security Number
27. most synarthroses are immovable joints held together by fibrous tissue.
Carcinoma (Ca) in situ
No ROM
Flat bones
Employer Liability
28. Number assigned to the physician by Medicare program.
False ribs
Malignant
Unique Provider Identification Number (UPIN)
Medicaid
29. Is the lower medial arm bone.
ulna
History
true ribs
Birthday rule
30. the bone is broken and the ends are driven into each other.
Benign
Impacted
Malignant
Subcategories
31. The bone is broken and pierces an internal organ
Alphabetic Index (Volume 2)
Employer Identification Number (EIN)
Medical Records
Complicated
32. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients
MEDICARE Part B
HCPCS Level I codes
Health Care Financing Administration Common Procedure Coding System
encounter form
33. 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
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Deductible
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Pre-paid Health Plan
34. '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
Pre-certification
Mutually Exclusive Edits
Musculoskeletal System
Employee Liability
35. 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.
Parietal Bones
co-payment
Coinsurance
Medicaid
36. 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
essential modifiers
Compression fracture
Fee-for-Service
Long bones
37. Represent changes in the text or definition between the triangles.
CPT SECTIONS.
ligaments
Established patient
Two triangular symbols (a
38. 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
Group Insurance
Disability insurance
Unspecified (hypertension)
39. 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
-26 - Professional Component
Participating physician
Category II Codes CPT
40. Medicare Managed Care Plans (Formerly Medicare Plus (+) Choice Plan) was created to offer a number of healthcare services in addition to those available under Part A and Part B. The CMS contracts with managed care plans or provider service organizati
axial skeleton
MEDICARE Part C
Unspecified nature
Outpatient
41. Are composed of three-digit codes representing a single disease or condition.
Inferior nasal conchae
Patient Confidentiality
Categories
Polyp
42. Contains complete - necessary information - but is incorrect or illogical in some way.
Outpatient
Remittance Advice
Invalid claim
Benign (hypertension)
43. The moon like white area at the base of the nail.
Abuse
Point-of-Service plan (POS)
lunula
Pre-authorization
44. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
The St. Anthony Relative Value for Physicians (RVP)
Impetigo
Mandible
45. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
Wheal
Pathologic
Health practitioner
Primary malignancy
46. 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.
Chief complaint (CC)
Group practice
Carpals
nonessential modifiers
47. open sore on the skin or mucous
The Good Samaritan Act
The Good Samaritan Act
Ulcermembranes
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
48. male of household is primary payer
Rejected claim
Gender rule
Sub classification
Undetermined
49. Represent services and procedures widely used by many health care professionals in clinical practice in multiple locations and have been approved by the FDA.
HCPCS Level II codes (National Codes)
Category I Codes CPT
The Integumentary System
Impetigo
50. A minor fracture appears as a thin line on x-ray and may not extend completely through the bone.
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Hairline
Maxilla
Paper Claim