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Test your basic knowledge |
Medical Billing And Coding Vocab
Start Test
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. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
Review of Systems (ROS)
Malignant
circle with a line through it)
Electronic Claim
2. Absence of hair from areas where it normally grows
Alopecia
Salter-Harris
Coding
Chief complaint
3. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.
Peer Review Organization (PRO)
MEDICAID COVERAGE
The St. Anthony Relative Value for Physicians (RVP)
The Integumentary System
4. poisoning was inflicted by another person with intent to kill or injure
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Keratin
Ethmoid Bone
Assault
5. A pregnant woman who has had at least one previous pregnancy.
Two triangular symbols (a
Exclusions and Limitations
Multigravida
Pelvis
6. Is an electronic or paper-based report of payment sent by the payer to the provider.
Remittance Advice
State License Number
ulna
Alopecia
7. This is not specified as benign or malignant in the diagnosis or medical record.
phalanges (phalanx.s)
Unspecified (hypertension)
Employer Liability
Alphabetic Index (Volume 2)
8. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.
Sections
Unique Provider Identification Number (UPIN)
Qualified diagnosis
Pre-certification
9. Number assigned by the insurance company to a physician who renders services to patients.
Provider Identification Number (PIN)
Clean claim
Point-of-Service plan (POS)
TRICARE
10. This consists of the patient's personal experiences with illnesses - surgeries and injuries. It also contains information of illnesses predominant in the family. It contains the patient's educational background - occupation - marital status - and oth
Capitated Rates
Ulcermembranes
Past - family and social history (PFSH)
Complicated
11. Absence of hair from areas where it normally grows
There are three layers to the skin
Exclusions and Limitations
Alopecia
Two triangular symbols (a
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
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
MEDICARE Part C
Relative Value Payment Schedules Method
Pelvis
13. 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
Unauthorized benefit
Full ROM
TRICARE
Sphenoid Bones
14. Is the qualifying factor or factors that must be met before a patient receives benefits.
Blue Cross/Blue Shield Plans
Polyp
Eligibility
Pelvis
15. 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
Electronic Claim
New patient
Relative Value Payment Schedules Method
Unauthorized benefit
16. The CPT manual is composed of eight sections. Each section begins with guidelines that provide specific coding rules for that section. Guidelines at the beginning of the section are applicable to all codes in the section - while notes that pertain t
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
CPT SECTIONS.
Modifiers
triangle (a
17. make up part of the roof of the mouth
Palatine bones
History of present illness (HPI)
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Pathologic
18. Produce secretions that allow the body to be moisturized or cooled.
sebaceous(oil) glands and the suddoriferous (sweat) glands
Gender rule
Ethmoid Bone
Inpatient
19. 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
Deductible
-99 - Multiple Modifiers
Invalid claim
ligaments
20. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Chief complaint
Chief complaint (CC)
No ROM
21. 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.
Medically needy
Nodule
Medicaid
encounter form
22. This is the inventory of the constitutional symptoms regarding the various body systems.
Review of Systems (ROS)
Sebaceous glands
Unique Provider Identification Number (UPIN)
Malignant
23. Contains complete - necessary information - but is incorrect or illogical in some way.
Exclusions and Limitations
Impetigo
Non-covered benefit
Invalid claim
24. 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
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Physician
25. A pregnant woman who has had at least one previous pregnancy.
triangle (a
Explanation of Benefits (EOB)
Sections
Multigravida
26. are small with irregular shapes. They are found in the wrist and ankle.
National Correct Coding Initiative (NCCI)
False Claims Act (FCA)
triangle (a
Short bones
27. Standard - fee-for-service - cost-sharing plan ; Extra - preferred provider organization ;Prime - health maintenance organization plan with a point-of-service option All of the above-mentioned plans covered under TRICARE - with the exception of Prime
Vomer
TRICARE PLANS
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Zygoma
28. is defined as one who has not received any medical services within the last three years.
Employee Liability
State License Number
New Patient
Unauthorized benefit
29. This consists of the patient's personal experiences with illnesses - surgeries and injuries. It also contains information of illnesses predominant in the family. It contains the patient's educational background - occupation - marital status - and oth
Unlisted Procedures Procedures
Past - family and social history (PFSH)
Social Security Number
Health Maintenance Organization (HMO)
30. Noninvasive - non-spreading - nonmalignant
Benign
Pre-certification
Melanin
Qualified diagnosis
31. 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
False ribs
Fissure
Disability insurance
32. uncertain whether benign or malignant; borderline malignancy
Uncertain behavior
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Peer Review Organization (PRO)
Section 3 Index to External Causes of Injury (E codes)
33. 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
Benign (hypertension)
MEDICARE Part A
Preferred Provider Organization (PPO)
-26 - Professional Component
34. Typically not used on the claim form unless the provider does not have an EIN.
Social Security Number
Sections
Group Provider Number
eponychium
35. is referred to as Supplementary Medical Insurance (SMI). This coverage is a supplement to Part A - which covers medical expenses - clinical laboratory services - home health care - outpatient hospital treatment - blood - and ambulatory surgical serv
Deductible
MEDICARE Part A
MEDICARE Part B
Non-covered benefit
36. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
Add-on codes
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Fiscal Intermediary
Health practitioner
37. The lower anterior part of the bone
Tabular List (Volume 1)...
Chief complaint (CC)
Pubic bone
Occipital Bone
38. 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..
Medically needy
Health Care Financing Administration Common Procedure Coding System
Fee Schedule
Musculoskeletal System
39. Prescription Drugs The Medicare Prescription Drug - Improvement - and Modernization Act enacted in December 2003 and began implementation in January 2006 where Medicare beneficiaries can enroll in the Medicare prescription drug plan. The beneficiari
Occipital Bone
Evaluation and Management Review
MEDICARE Part D
Frontal Bone
40. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
Subcategories
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Health Insurance Portability and Accountability Act (HIPAA)
MEDICARE Part C
41. Is the lateral lower arm bone (in line with the thumb).
Radius
Exclusions and Limitations
Spinal/Vertebral Column
Advance Beneficiary Notice
42. The main term in the index may by followed by terms within parenthesis.
Alphabetic Index (Volume 2)
Consultation
stand-alone codes
Occipital Bone
43. major skin pigment
The Integumentary System
Melanin
MEDICAID COVERAGE
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
44. 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
Hairline
Keratin
Humerus
Electronic Claim
45. 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
Comminuted fracture
Sebaceous glands
Birthday rule
Macule
46. Numbers 1-7 - attach directly to the sternum in the front of the body.
Personal Insurance
Musculoskeletal System
true ribs
Health Maintenance Organization (HMO)
47. Is when two insurance companies work together to coordinate payment of the benefits.
Coordination of Benefits (COB)
Health Care Financing Administration Common Procedure Coding System
Medical Records
False ribs
48. .. lower jaw bone.
Fraud
Short bones
History of present illness (HPI)
Mandible
49. 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
Health practitioner
-51 - Multiple Procedures
Fee Schedule
Group Insurance
50. Represent changes in the text or definition between the triangles.
Non-covered benefit
Group Insurance
Two triangular symbols (a
The Good Samaritan Act