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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.
If you are not ready to take this test, you can
study here
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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. 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
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
False ribs
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
2. Represents a new procedure or service code added since the previous edition of the manual.
Pre-authorization
bullet (a
Capitated Rates
-99 - Multiple Modifiers
3. Families - pregnant women - and children ;Aid to Families with Dependent Children (AFDC)-related groups ;Non-AFDC pregnant women and children;Aged and disabled persons ;Supplemental Security Income (SSI)-related groups ;Qualified Medicare Beneficiari
Categorically needy -MEDICAID
The Good Samaritan Act
Preferred Provider plan
phalanges (phalanx.s)
4. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
appendicular skeleton .
Primary malignancy
circle with a line through it)
essential modifiers
5. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Colles
Accept assignment
Malignant
Nodule
6. 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
Maxilla
Dirty claim
Health practitioner
Maxilla
7. Is a policy that covers losses to a third party caused by the insured - by an object owned by the insured - or on premises owned by the insured. Liability insurance claims are made to cover the cost of medical care for traumatic injuries - lost wages
Liability insurance
Deductible
Section 3 Index to External Causes of Injury (E codes)
Medically needy
8. Deficient in pigment (melanin)
Neoplasm Table
Indemnity Insurance
Albino
Carcinoma (Ca) in situ
9. Is one who has received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years....
Vomer
History of present illness (HPI)
Established patient
The Universal Claim Form
10. A pregnant woman who has had at least one previous pregnancy.
Multigravida
Contracted Rates with MCOs
Invalid claim
lunula
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
Established Patient
true ribs
Outpatient
Paper Claim
12. 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.
Medical Records
Unspecified (hypertension)
Zygoma
Subcategories
13. Is a working diagnosis which is not yet established.
Qualified diagnosis
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Pubic bone
Ischium
14. are small with irregular shapes. They are found in the wrist and ankle.
-50 - Bilateral Procedure
Indemnity Insurance
Employer Liability
Short bones
15. 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
HCPCS Level I codes
Salter-Harris
Vomer
16. 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
Salter-Harris
Medigap (Medicare Supplemental Insurance)
Past - family and social history (PFSH)
Spinal/Vertebral Column
17. Forms the sides of the cranium
Sections
-26 - Professional Component
Unique Provider Identification Number (UPIN)
Parietal Bones
18. Physicians agree to provide services at a discount of their usual fee in return for a pool of existing patients.
Sesamoid bones
CPT SECTIONS.
Fee Schedule
Contracted Rates with MCOs
19. 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.
National Correct Coding Initiative (NCCI)
Macule
Albino
MEDICAID COVERAGE
20. 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.
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Modifiers
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Zygoma
21. Structural protein found in the skin and connective tissue
Category II Codes CPT
Subcategories
State License Number
Collagen
22. Contains complete - necessary information - but is incorrect or illogical in some way.
Invalid claim
Pre-certification
Occipital Bone
Chief complaint
23. The main term in the index may by followed by terms within parenthesis.
Subcategories
Albino
The Universal Claim Form
Alphabetic Index (Volume 2)
24. open sore on the skin or mucous
Civil Monetary Penalties Law (CMPL)
Ulcermembranes
Compression fracture
Qualified diagnosis
25. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.
Rejected claim
Carcinoma (Ca) in situ
Health Care Financing Administration Common Procedure Coding System
Limited ROM
26. 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.
Musculoskeletal System
Category III Codes CPT
Categories
Clean claim
27. Is the cost of insurance coverage paid annually - semi-annually or monthly to keep a policy in effect.
Coordination of Benefits (COB)
Fissure
Medigap (Medicare Supplemental Insurance)
premium
28. 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
Palatine bones
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Category III Codes CPT
29. Number assigned by the insurance company to a physician who renders services to patients.
Provider Identification Number (PIN)
State License Number
premium
MEDICARE Part A
30. Pre-determined set of benefits covered under one set annual fee.
Hypertension Table
Pre-paid Health Plan
Impetigo
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
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
Medicare Claim Status
Preferred Provider Organization (PPO)
bullet (a
-99 - Multiple Modifiers
32. A fracture of the epiphyseal plate in children.
Inpatient
Salter-Harris
Fee Schedule
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
33. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
Consultation
Full ROM
Nodule
Categories
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
Primary malignancy
Subcategories
There are three layers to the skin
Maxilla
35. Is the qualifying factor or factors that must be met before a patient receives benefits.
Medical Records
Eligibility
Unique Provider Identification Number (UPIN)
Remittance Advice
36. Is an electronic or paper-based report of payment sent by the payer to the provider.
Remittance Advice
axial skeleton
Category I Codes CPT
Category I Codes CPT
37. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Alphabetic Index (Volume 2)
New patient
Categories
Unspecified nature
38. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).
Medical necessity
Column 1/Column 2 (previously called Comprehensive/Component) Edits
New patient
Patient Confidentiality
39. 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
Accept assignment
axial skeleton
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Social Security Number
40. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the
MEDICARE Part A
Paper Claim
CPT SECTIONS.
Medigap (Medicare Supplemental Insurance)
41. uncertain whether benign or malignant; borderline malignancy
Uncertain behavior
The Patient Care Partnership (Patient's Bill of Rights)
nonessential modifiers
Location Methods
42. the bone is broken and the ends are driven into each other.
Fee Schedule
Impacted
Complicated
Point-of-Service plan (POS)
43. Pre-determined set of benefits covered under one set annual fee.
eponychium
Pre-paid Health Plan
Parietal Bones
Albino
44. Are located in the dermal layer of the skin over the entire body - except for the palms of the hands and soles of the feet. The sebaceous glands secrete an oily substance called sebum. Sebum contains lipids that help lubricate the skin and minimize w
Sebaceous glands
Malignant
Lacrimal bones
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
45. 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
Short bones
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
HCPCS Level II codes (National Codes)
Long bones
46. This modifier is used when the same procedure is performed on a mirror-image part of the body..
-50 - Bilateral Procedure
Participating physician
Health Maintenance Organization (HMO)
Coordination of Benefits (COB)
47. Contains complete - necessary information - but is incorrect or illogical in some way.
Invalid claim
Review of Systems (ROS)
Pubic bone
Comminuted fracture
48. Is the lower medial arm bone.
sprain
ulna
Social Security Number
Alopecia
49. This is a set of information the physician gathers from the patient regarding the following:
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
There are three layers to the skin
Lacrimal bones
History
50. 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.
Unlisted Procedures Procedures
A plus sign (+)
Medicare Claim Status
Abuse