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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.
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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. The reason the patient came to see the physician.
Chief complaint (CC)
eponychium
circle with a line through it)
Fiscal Intermediary
2. forms the two lower sides of the cranium.
Medicare Claim Status
Health Maintenance Organization (HMO)
Temporal Bone
Contracted Rates with MCOs
3. Is defined by Medicare as 'the determination that a service or procedure rendered is reasonable and necessary for the diagnosis or treatment of an illness or injury.'
MEDICARE Part C
Coordination of Benefits (COB)
History of present illness (HPI)
Medical necessity
4. Was developed to promote the interests and well being of the patients and residents of the healthcare facility. This bill has still not become a law.
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5. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
Carcinoma (Ca) in situ
Neoplasm Table
essential modifiers
MEDICARE Part C
6. This modifier is used when: more than one procedure is performed during the same surgical episode; one code does not describe all of the procedures performed; and the secondary procedure is not minor or incidental to the major procedure. The followin
Paper Claim
-51 - Multiple Procedures
Benign (hypertension)
Collagen
7. open sore on the skin or mucous
Greenstick
Musculoskeletal System
Ulcermembranes
Established Patient
8. the bone is broken and the ends are driven into each other.
Personal Insurance
Impacted
Retention of Medical Records
Fee-for-Service
9. Deficient in pigment (melanin)
Ischium
The St. Anthony Relative Value for Physicians (RVP)
Albino
Relative Value Payment Schedules Method
10. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Uncertain behavior
Paper Claim
Categories
Coding
11. Retention of medical records is governed by state and local laws and may vary from state-to-state. Most physicians are required to retain records indefinitely; deceased patient records should be kept for at least five (5) years.
Retention of Medical Records
Macule
Established patient
False Claims Act (FCA)
12. Is when two insurance companies work together to coordinate payment of the benefits.
Explanation of Benefits (EOB)
Alopecia
Wheal
Coordination of Benefits (COB)
13. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
Add-on codes
Full ROM
No ROM
Lacrimal bones
14. death of tissue associated with loss of blood supply
Gangrene
Complicated
Advance Beneficiary Notice
Salter-Harris
15. 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
-99 - Multiple Modifiers
History
Categories
stand-alone codes
16. Is a state-required insurance plan - the coverage of which provides benefits to employees and their dependents for work related injury - illness or death. Each state has an established minimum number of employees required before this law comes into e
Suicide Attempt
Workers Compensation
False ribs
Hypertension Table
17. - 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)
Chapters
Fiscal Intermediary
There are three layers to the skin
18. major skin pigment
Melanin
Compliance Regulations
The St. Anthony Relative Value for Physicians (RVP)
Clearinghouse
19. Is the upper arm bone.
Temporal Bone
Humerus
Accident
Two triangular symbols (a
20. Are supplemental codes used for performance measurements. Although these codes are intended to facilitate data collection about the quality of care - their use is optional. Category II codes are published twice a year: January 1st and July 1st.
MEDICARE Part A
bullet (a
Add-on codes
Category II Codes CPT
21.
Birthday rule
Sphenoid Bones
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Frontal Bone
22. requires investigation and needs further clarification.
Preferred Provider plan
HCPCS Level I codes
Rejected claim
Health practitioner
23. 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
Nonparticipating physician
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Unique Provider Identification Number (UPIN)
Unlisted Procedures Procedures
24. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Workers Compensation
Mutually Exclusive Edits
Liability insurance
sprain
25. solid - round or oval elevated lesion more than 1 cm in diameter
Chief complaint
appendicular skeleton .
TRICARE PLANS
Nodule
26. The lower anterior part of the bone
Relative Value Payment Schedules Method
Pubic bone
eponychium
TRICARE PLANS
27. Represents a change in the code description since the last edition. The change may be minor or significant and it could be an addition - deletion or revision.
triangle (a
Advance Beneficiary Notice
Fiscal Intermediary
Group Provider Number
28. Represent services and procedures widely used by many health care professionals in clinical practice in multiple locations and have been approved by the FDA.
ulna
Category I Codes CPT
Full ROM
The St. Anthony Relative Value for Physicians (RVP)
29. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Contracted Rates with MCOs
Unspecified nature
Melanin
Category I Codes CPT
30. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
Fraud
Participating physician
Secondary malignancy
Long bones
31. Any fracture occurring spontaneously as a result of disease.
Alphabetic Index (Volume 2)
Workers Compensation
Occipital Bone
Pathologic
32. Absence of hair from areas where it normally grows
Subcategories
sprain
Location Methods
Alopecia
33. 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
Parietal Bones
Coding
Medicare
34.
Coordination of Benefits (COB)
Uncertain behavior
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
35. Also called 'global surgery' - includes a variety of services rendered by a surgeon which includes the following: Surgical procedure performed Local infiltration - metacarpal/metatarsal/digital block - or topical anesthesia Preoperative E/M services
MEDICARE Part C
Surgical Package
lunula
Fraud
36. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
Greenstick
Health Insurance Portability and Accountability Act (HIPAA)
Accept assignment
Rib Cage
37. Structural protein found in the skin and connective tissue
Polyp
Sub classification
Collagen
stand-alone codes
38. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body
Occipital Bone
Nonparticipating physician
Secondary malignancy
There are three layers to the skin
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
Medicare
Medical necessity
Subcategories
Established patient
40. The main term in the index may by followed by terms within parenthesis.
Exclusions and Limitations
Alphabetic Index (Volume 2)
Nodule
Comminuted fracture
41. Is the cost of insurance coverage paid annually - semi-annually or monthly to keep a policy in effect.
Frontal Bone
State License Number
Hairline
premium
42. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Fiscal Intermediary
Chief complaint
nonessential modifiers
Rejected claim
43. 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
MEDICARE Part B
Evaluation and Management Review
Sebaceous glands
Albino
44. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Accept assignment
lunula
Fee Schedule
itemized statement
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
Non-covered benefit
MEDICARE Part C
HCPCS Level II codes (National Codes)
Ethmoid Bone
46. Number assigned to the physician by Medicare program.
-50 - Bilateral Procedure
Unique Provider Identification Number (UPIN)
Hypertension Table
Participating physician
47. A chronological account of the development of the complaint from the first sign or symptom that the patient experienced to the present
History of present illness (HPI)
Radius
Unspecified (hypertension)
Zygoma
48. Physicians agree to provide services at a discount of their usual fee in return for a pool of existing patients.
Flat bones
Employee Liability
Contracted Rates with MCOs
Malignant
49. Is an electronic or paper-based report of payment sent by the payer to the provider.
essential modifiers
Eligibility
Remittance Advice
Health Maintenance Organization (HMO)
50. 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..
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Malignant
Musculoskeletal System
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
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