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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.
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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. 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.
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Fee Schedule
Medical Records
Chief complaint (CC)
2. The bone is broken and pierces an internal organ
Consultation
Complicated
Medically needy
Palatine bones
3. 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
Outpatient
Paper Claim
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Deductible
4. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
Eligibility
Full ROM
Compliance Regulations
Liability insurance
5. This modifier is used to report a procedure or service that has more than one Modifier but the third-party payer does not allow the addition of multiple modifiers to the code. Modifier -99 is attached to the procedure code and the multiple Modifiers
-99 - Multiple Modifiers
MEDICARE Part D
Flat bones
Chapters
6. 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
Zygoma
MEDICARE Part C
Medical necessity
Fraud
7. 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
HCPCS Level II codes (National Codes)
Personal Insurance
Secondary malignancy
Category III Codes CPT
8. There are also terms indented two spaces to the right below the main term called subterms. These subterms are because they have bearing in the selection of the right code. Everything in the Index is listed by condition - that is - diagnosis - signs -
Eligibility
Coding
Peer Review Organization (PRO)
essential modifiers
9. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Mandible
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Employer Identification Number (EIN)
Explanation of Benefits (EOB)
10. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
Flat bones
Group Insurance
Coinsurance
Tabular List (Volume 1)...
11. Most procedures have both professional (physician) and technical components. This modifier is attached to the procedure to indicate that the physician provided only the professional component.
-26 - Professional Component
Neoplasm Table
Vesicle
Nodule
12. 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
Gender rule
Mandible
-51 - Multiple Procedures
Medicare
13. 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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14. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
Unauthorized benefit
Rib Cage
Colles
Impacted
15. - To pay for medical services and items that Medicare does not cover and Medicare's coinsurance and deductibles - beneficiaries may purchase a supplemental insurance. Medigap is a private insurance designed to help pay for those amounts that are typ
Medigap (Medicare Supplemental Insurance)
Sebaceous glands
-90 - Reference (Outside) Laboratory
Hypertension Table
16. Considered experimental - newly approved - or seldom used may not be listed in the CPT manual. These codes can be coded as unlisted procedures. They are located at the end of the subsections or subheadings. When an unlisted procedure code is reported
Unlisted Procedures Procedures
Medicare
Vomer
Frontal Bone
17. 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
The Current Procedural Terminology (CPT)
Medicare
Commercial Carriers
Group Provider Number
18. 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
Employer Liability
Consultation
phalanges (phalanx.s)
Lipocyte
19. 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.
Employer Liability
Radius
Ethmoid Bone
Modifiers
20. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Coding
TRICARE PLANS
Mutually Exclusive Edits
Pre-determination
21. death of tissue associated with loss of blood supply
MEDICARE Part D
Two triangular symbols (a
Established patient
Gangrene
22. 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.
Category I Codes CPT
Inpatient
Medicaid
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
23. 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.
Keratin
Medicare Claim Status
Relative Value Payment Schedules Method
true ribs
24. Is the upper arm bone.
Humerus
Performing Provider Identification Number (PPIN)
Compliance Regulations
Primary malignancy
25. The poisoning was self-inflicted.
Primary malignancy
Suicide Attempt
Commercial Carriers
Consultation
26. 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.
phalanges (phalanx.s)
Sections
Benign (hypertension)
National Correct Coding Initiative (NCCI)
27. Number assigned by the insurance company to a physician who renders services to patients.
premium
Parietal Bones
Provider Identification Number (PIN)
Benign
28. This is the inventory of the constitutional symptoms regarding the various body systems.
Group Insurance
Remittance Advice
Flat bones
Review of Systems (ROS)
29. 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
phalanges (phalanx.s)
MEDICARE Part B
Uncertain behavior
Relative Value Payment Schedules Method
30. 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
ulna
Primary malignancy
TRICARE
Retention of Medical Records
31. 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
False Claims Act (FCA)
Qualified diagnosis
co-payment
32. The lower anterior part of the bone
Pubic bone
Subcategories
Category I Codes CPT
State License Number
33.
Accident
Unauthorized benefit
Long bones
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
34. 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
The Good Samaritan Act
Lacrimal bones
False ribs
35. 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
Medical necessity
Medical necessity
Albino
Relative Value Payment Schedules Method
36. Discolored - flat lesion (freckles - tattoo marks)
Indemnity Insurance
Secondary malignancy
Macule
Accident
37. Contains complete - necessary information - but is incorrect or illogical in some way.
Chief complaint (CC)
Sesamoid bones
Alphabetic Index (Volume 2)
Invalid claim
38. 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
Preferred Provider Organization (PPO)
Lipocyte
-90 - Reference (Outside) Laboratory
Patient Confidentiality
39. paired bones at the corner of each eye that cradle the tear ducts.
Lacrimal bones
Abuse
Albino
Unique Provider Identification Number (UPIN)
40. Knowingly and intentionally deceiving or misrepresenting information that may result in unauthorized benefits is known as fraud.. Common forms of fraud are billing for services not furnished - unbundling - and misrepresenting diagnosis to justify pay
Fraud
Uncertain behavior
MEDICARE Part D
Alphabetic Index (Volume 2)
41. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
Pre-authorization
The Good Samaritan Act
Collagen
Maxilla
42. forms the roof of the nasal cavity.
Hypertension Table
Ethmoid Bone
Sesamoid bones
Lipocyte
43. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
Complicated
Patient Confidentiality
Full ROM
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
44. 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.
Pre-paid Health Plan
Categorically needy -MEDICAID
Advance Beneficiary Notice
Sub classification
45. 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
Blue Cross/Blue Shield Plans
Occipital Bone
lunula
Musculoskeletal System
46. Benign growth extending from the surface of the mucous membrane
Polyp
Preferred Provider plan
Alphabetic Index (Volume 2)
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
47. 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
Comminuted fracture
Alphabetic Index (Volume 2)
Review of Systems (ROS)
48. This modifier is used to report a procedure or service that has more than one Modifier but the third-party payer does not allow the addition of multiple modifiers to the code. Modifier -99 is attached to the procedure code and the multiple Modifiers
-99 - Multiple Modifiers
Fiscal Intermediary
Gender rule
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
49. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body
Sesamoid bones
There are two types of sweat glands
Secondary malignancy
Pre-authorization
50. Is a cost-sharing requirement for the insured to pay at the time of service. This amount is usually a specific dollar amount (e.g.. $15 - $20 - $25)
Medicare Claim Status
Carpals
co-payment
Advance Beneficiary Notice