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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.
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. major skin pigment
Carpals
Outpatient
New patient
Melanin
2. death of tissue associated with loss of blood supply
Gangrene
-32 - Mandated Services
Medical necessity
Electronic Claim
3. This is any procedure or service reported on the insurance claim that is not listed in the payer's master benefit list. This will result in the denial of the claim. Providers may be able to recover the charges from the patient.
-50 - Bilateral Procedure
Non-covered benefit
Unauthorized benefit
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
4. 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.
Albino
-99 - Multiple Modifiers
Category III Codes CPT
Clean claim
5. Absence of hair from areas where it normally grows
Alopecia
The Good Samaritan Act
Fee-for-Service
Patient Confidentiality
6. forms the roof of the nasal cavity.
The Universal Claim Form
Ethmoid Bone
False Claims Act (FCA)
Medical necessity
7. make up part of the roof of the mouth
Health practitioner
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Unspecified (hypertension)
Palatine bones
8. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
Exclusions and Limitations
Mutually Exclusive Edits
Capitated Rates
The Good Samaritan Act
9. This is any procedure or service reported on the insurance claim that is not listed in the payer's master benefit list. This will result in the denial of the claim. Providers may be able to recover the charges from the patient.
Non-covered benefit
-90 - Reference (Outside) Laboratory
Coinsurance
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
10. Most billing-related cases are based on HIPAA and False Claims Act.
There are two types of sweat glands
National Correct Coding Initiative (NCCI)
Physician
Compliance Regulations
11. A minor fracture appears as a thin line on x-ray and may not extend completely through the bone.
MEDICARE Part D
Hairline
Unique Provider Identification Number (UPIN)
The Patient Care Partnership (Patient's Bill of Rights)
12. Bone that forms posterior/inferior part of the nasal septal wall between the nostrils.
Invalid claim
Section 3 Index to External Causes of Injury (E codes)
TRICARE PLANS
Vomer
13. Any fracture occurring spontaneously as a result of disease.
eponychium
MEDICARE Part A
Pathologic
No ROM
14. paired bones at the corner of each eye that cradle the tear ducts.
Lacrimal bones
Sub classification
Frontal Bone
Health Maintenance Organization (HMO)
15. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
MEDICARE Part A
Nodule
Health Insurance Portability and Accountability Act (HIPAA)
Assault
16. 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.
Preferred Provider Organization (PPO)
Health practitioner
Modifiers
Employer Liability
17. 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)
Unauthorized benefit
Paper Claim
Pre-determination
18. 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
Electronic Claim
Macule
MEDICARE Part B
Multigravida
19. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.
Vesicle
Retention of Medical Records
encounter form
Categorically needy -MEDICAID
20. Is one who has no contract with the health insurance plan.
Rejected claim
State License Number
History
Nonparticipating physician
21. 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
Limited ROM
Patient Confidentiality
Alphabetic Index (Volume 2)
Colles
22. Is a working diagnosis which is not yet established.
Qualified diagnosis
TRICARE
Mutually Exclusive Edits
Consultation
23. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Health Insurance Portability and Accountability Act (HIPAA)
itemized statement
Mutually Exclusive Edits
Chief complaint
24. Are wrist bones. There are 2 rows of four bones in the wrist. The metacarpals are the five radiating bones in the fingers. These are the bones in the palm of the hand.
Pre-determination
Social Security Number
Carpals
False Claims Act (FCA)
25. 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.
Modifiers
Radius
Unspecified nature
Compression fracture
26. 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
Medical necessity
Keratin
Sections
Commercial Carriers
27. The poisoning was self-inflicted.
Employee Liability
Suicide Attempt
Benign
New patient
28. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the
Compression fracture
Medical Records
nonessential modifiers
MEDICARE Part A
29. 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
Carpals
ligaments
Fee-for-Service
Fraud
30. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.
Primary malignancy
Greenstick
MEDICARE Part C
Abuse
31. 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
Location Methods
Vesicle
Clearinghouse
Medicare
32. The break of the distal end of the radius at the epiphysis often occurs when the patient has attempted to break his or her fall.
Albino
Category II Codes CPT
Colles
Performing Provider Identification Number (PPIN)
33. This number is used instead of the individual physician's number for the performing provider who is a member of a group practice that submits claims to insurance companies under the group name.
Group Provider Number
Compliance Regulations
Patient Confidentiality
Maxilla
34. Poisoning cannot be determined whether intentional or accidental.
Unspecified (hypertension)
Undetermined
Fee-for-Service
Sub classification
35. The moon like white area at the base of the nail.
Unlisted Procedures Procedures
Employee Liability
Malignant
lunula
36. Are the finger bones. Each finger has three phalanges - except for the thumb. The three phalanges are the proximal - middle and a distal phalanx. The thumb has a proximal and distal.
Paper Claim
Advance Beneficiary Notice
Assault
phalanges (phalanx.s)
37. Is defined as someone who has received medical services with in the last 3 years from the physician or another physician of the same specialty who belongs to the same group practice.
Established Patient
Spinal/Vertebral Column
Provider Identification Number (PIN)
Chief complaint
38. 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.
Advance Beneficiary Notice
HCPCS Level I codes
Fiscal Intermediary
ulna
39. 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.
40. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
The Good Samaritan Act
circle with a line through it)
Fissure
Lipocyte
41. most synarthroses are immovable joints held together by fibrous tissue.
Secondary malignancy
No ROM
Vomer
Fissure
42. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
Tabular List (Volume 1)...
Wheal
Coordination of Benefits (COB)
New Patient
43. It is important that every patient seen by the physician has comprehensive legible documentation about the patient's illness - treatment and plans for the following reasons Avoidance of denied or delayed payments by insurance carriers investigating t
Alopecia
CPT SECTIONS.
Established Patient
Reasons for Documentation
44. 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
Health Care Financing Administration Common Procedure Coding System
Past - family and social history (PFSH)
Assault
Coding
45. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.
lunula
Limited ROM
Modifiers
bullet (a
46. Is defined as a doctor of medicine or osteopathy - dental medicine - dental surgery - podiatric medicine - optometry - or chiropractic medicine legally authorized to practice by the state in which he/she performs.
-90 - Reference (Outside) Laboratory
Physician
Secondary malignancy
Qualified diagnosis
47. 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
There are two types of sweat glands
Capitated Rates
Review of Systems (ROS)
Neoplasm Table
48. Is a managed care plan that gives beneficiaries the option whom to see for services. If the beneficiary goes to see a physician within the network - s/he will receive benefits similar to an HMO. But if the beneficiary chooses to see a physician from
Short bones
Undetermined
Point-of-Service plan (POS)
Rib Cage
49. 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
There are two types of sweat glands
Peer Review Organization (PRO)
HCPCS Level II codes (National Codes)
Modifiers
50. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Remittance Advice
Established Patient
Employer Identification Number (EIN)
Paper Claim