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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. 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
Fiscal Intermediary
The Integumentary System
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Occipital Bone
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
Add-on codes
Category II Codes CPT
Paper Claim
Group Provider Number
3. A fat cell
Lipocyte
Accident
Past - family and social history (PFSH)
Alphabetic Index (Volume 2)
4. Under capitation - the physician provides a full range of contracted services to covered patients for a fixed amount on a periodic basis. While guaranteed a fixed amount - the physician assumes the risk that the cost of providing the care to the pati
Capitated Rates
No ROM
Compression fracture
circle with a line through it)
5. The moon like white area at the base of the nail.
Flat bones
The St. Anthony Relative Value for Physicians (RVP)
lunula
MEDICAID COVERAGE
6. Typically not used on the claim form unless the provider does not have an EIN.
Hairline
Group Insurance
Group practice
Social Security Number
7. forms the two lower sides of the cranium.
Chapters
co-payment
Temporal Bone
Modifiers
8. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
Health Maintenance Organization (HMO)
Primary malignancy
Compression fracture
Established Patient
9. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body
Impetigo
Coding
Secondary malignancy
Limited ROM
10. death of tissue associated with loss of blood supply
National Correct Coding Initiative (NCCI)
Disability insurance
Radius
Gangrene
11. They are for profit organizations that operate in the private sector selling different health insurance benefits plans to groups or individuals. Most commercial plans have predefined patient yearly deductibles and coinsurance generally based on 80/2
Preferred Provider plan
-50 - Bilateral Procedure
Commercial Carriers
Impetigo
12. 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
Location Methods
Remittance Advice
co-payment
Health practitioner
13. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Capitated Rates
Electronic Claim
Accept assignment
Comminuted fracture
14. Physicians are legally responsible for their own conduct and any actions of their employees (their designee) performed within the context of their employment. This is referred to as 'vicarious liability -' also known as 'respondent superior -' which
Employer Liability
-99 - Multiple Modifiers
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Nodule
15. Is a regionally managed healthcare program for active duty and retired members of the armed forces - their families - and survivors. It is a service benefit program and contains no premium. TRICARE is the new title for the CHAMPUS program (Civilian H
Flat bones
Temporal Bone
History
TRICARE
16. 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
MEDICARE Part C
Section 3 Index to External Causes of Injury (E codes)
Macule
Disability insurance
17. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
appendicular skeleton .
Collagen
Radius
Employer Identification Number (EIN)
18. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.
Sections
Limited ROM
Malignant
Medicare
19. Is a statement of the patient's account history - showing dates of service - detailed charges - payments (i.e. deductibles and co-pays) - the date the insurance claim was submitted - applicable adjustments and account balance.
TRICARE
itemized statement
Group practice
Fiscal Intermediary
20. The bone is broken and pierces an internal organ
Surgical Package
Complicated
Social Security Number
Invalid claim
21. 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
Multigravida
Neoplasm Table
Lacrimal bones
Polyp
22. Contain the full description of the procedure for the code indented codes: these are codes listed under associated stand-alone codes. To complete the description for indented codes - one must refer to the portion of the stand alone code description b
stand-alone codes
Benign (hypertension)
Alphabetic Index (Volume 2)
Uncertain behavior
23. 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
The Universal Claim Form
circle with a line through it)
Benign (hypertension)
Medigap (Medicare Supplemental Insurance)
24. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
Carcinoma (Ca) in situ
Complicated
Medigap (Medicare Supplemental Insurance)
Alopecia
25. Is made up of the shoulder - collar - pelvic and arms and legs
appendicular skeleton .
Chief complaint (CC)
Chief complaint
Add-on codes
26. Forms the sides of the cranium
Contracted Rates with MCOs
eponychium
Parietal Bones
Ischium
27. The Usual - Customary - and Reasonable: The UCR method is used mostly in reference to fee-for-service reimbursement. To arrive at a payment amount for a claim - the carrier compares: The physician's most frequent charge for a given service (the usual
Fee Schedule
Remittance Advice
Exclusions and Limitations
Medical Records
28. 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.
Collagen
Section 3 Index to External Causes of Injury (E codes)
MEDICARE Part B
Humerus
29. 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
Nodule
Group practice
Patient Confidentiality
Civil Monetary Penalties Law (CMPL)
30. Is the federal government's health insurance program created by the Social Security Act of 1965 titled 'Health Insurance for the Aged and Disabled'. It is administered by the Centers for Medicare and Medicaid Services (CMS) - formerly known as Health
Medicare
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Modifiers
Albino
31. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
ligaments
Medically needy
Sections
sebaceous(oil) glands and the suddoriferous (sweat) glands
32. 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
Fee-for-Service
Employer Identification Number (EIN)
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Fiscal Intermediary
33. Number assigned by the insurance company to a physician who renders services to patients.
Provider Identification Number (PIN)
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Retention of Medical Records
Clearinghouse
34. This is a set of information the physician gathers from the patient regarding the following:
bullet (a
History
Categories
-50 - Bilateral Procedure
35. 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
Preferred Provider plan
Accident
triangle (a
Short bones
36. uncertain whether benign or malignant; borderline malignancy
False ribs
Uncertain behavior
Categories
Compliance Regulations
37. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
phalanges (phalanx.s)
Location Methods
Pre-certification
Wheal
38. 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
appendicular skeleton .
Civil Monetary Penalties Law (CMPL)
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Inpatient
39. Is the upper arm bone.
Humerus
Contracted Rates with MCOs
Neoplasm Table
Malignant
40. 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
41. 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.
Tabular List (Volume 1)...
Sphenoid Bones
Short bones
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
42. paired bones at the corner of each eye that cradle the tear ducts.
Collagen
Lacrimal bones
MEDICARE Part D
CPT SECTIONS.
43. The lower anterior part of the bone
Invalid claim
Pubic bone
Fraud
New patient
44. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
ulna
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Flat bones
co-payment
45. 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
Sesamoid bones
circle with a line through it)
MEDICARE Part C
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
46. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.
Short bones
Greenstick
Ulcermembranes
Wheal
47. Represent changes in the text or definition between the triangles.
The Integumentary System
Ulcermembranes
Two triangular symbols (a
The Integumentary System
48. 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
Modifiers
Occipital Bone
Parietal Bones
49. Under capitation - the physician provides a full range of contracted services to covered patients for a fixed amount on a periodic basis. While guaranteed a fixed amount - the physician assumes the risk that the cost of providing the care to the pati
Capitated Rates
itemized statement
Maxilla
History of present illness (HPI)
50. 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.
Compression fracture
Category III Codes CPT
Assault
Melanin