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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.
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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 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.
Category II Codes CPT
Sphenoid Bones
Fee-for-Service
sebaceous(oil) glands and the suddoriferous (sweat) glands
2. numbers 8-10 - are attached to the sternum by cartilage
Spinal/Vertebral Column
False ribs
Keratin
Explanation of Benefits (EOB)
3. This is not specified as benign or malignant in the diagnosis or medical record.
Electronic Claim
Unspecified (hypertension)
Commercial Carriers
Advance Beneficiary Notice
4. Are composed of three-digit codes representing a single disease or condition.
Categories
Compliance Regulations
Rejected claim
Remittance Advice
5. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.
Carpals
encounter form
Exclusions and Limitations
Fee Schedule
6. Cheekbone
Zygoma
Nonparticipating physician
Frontal Bone
Melanin
7. 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.
Maxilla
-90 - Reference (Outside) Laboratory
Dirty claim
Physician
8. 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
Non-covered benefit
Secondary malignancy
Commercial Carriers
Benign (hypertension)
9. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called
Long bones
Sesamoid bones
Keratin
Pre-certification
10. 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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11. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
upper appendicular skeleton
Carpals
Medicare Claim Status
Fiscal Intermediary
12. open sore on the skin or mucous
A plus sign (+)
Birthday rule
Ethmoid Bone
Ulcermembranes
13. 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
Musculoskeletal System
Wheal
Mutually Exclusive Edits
Workers Compensation
14. Discolored - flat lesion (freckles - tattoo marks)
sebaceous(oil) glands and the suddoriferous (sweat) glands
Palatine bones
Macule
Accident
15. 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.
Category III Codes CPT
Compression fracture
Zygoma
Medigap (Medicare Supplemental Insurance)
16. Absence of hair from areas where it normally grows
Medically needy
Alopecia
New patient
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
17. 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
Undetermined
Patient Confidentiality
Non-covered benefit
Carcinoma (Ca) in situ
18. Groove or crack like sore
Fissure
Neoplasm Table
Physician
Macule
19. Absence of hair from areas where it normally grows
Pelvis
Alopecia
Peer Review Organization (PRO)
Paper Claim
20. the bone is broken and the ends are driven into each other.
Impacted
Categorically needy -MEDICAID
Reasons for Documentation
-99 - Multiple Modifiers
21. HCPCS Reference Manual The CMS assigns a standard unique identifier known as the National Provider Identifier (NPI) The CMS also developed a two-part coding system called the Healthcare Common Procedure Coding System ( HCPCS ) which is a collection o
Employer Identification Number (EIN)
Keratin
Electronic Claim
Health Care Financing Administration Common Procedure Coding System
22.
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
The Current Procedural Terminology (CPT)
Hypertension Table
Medicaid
23. 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).
TRICARE PLANS
Sections
Pre-determination
Nonparticipating physician
24. most synarthroses are immovable joints held together by fibrous tissue.
No ROM
Fraud
nonessential modifiers
Flat bones
25. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
Carcinoma (Ca) in situ
Parietal Bones
Medical necessity
-26 - Professional Component
26. 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....
Established patient
Health Maintenance Organization (HMO)
Employer Liability
Column 1/Column 2 (previously called Comprehensive/Component) Edits
27. Further classified as to primary - secondary - or carcinoma in situ.
False ribs
Malignant
Melanin
Nonparticipating physician
28. Physicians are legally responsible for their own conduct and any actions of their employees (their designee) performed within the context of their employment. This is referred to as 'vicarious liability -' also known as 'respondent superior -' which
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
axial skeleton
Wheal
Employer Liability
29. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
CPT SECTIONS.
Accept assignment
Compression fracture
Chief complaint
30. are small with irregular shapes. They are found in the wrist and ankle.
Impetigo
Short bones
The Integumentary System
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
31. major skin pigment
Melanin
State License Number
Health Insurance Portability and Accountability Act (HIPAA)
Category III Codes CPT
32. This modifier is used to explain that the procedure or service done during a postoperative period was planned at the time of the original procedure. This is also used if a therapeutic procedure is performed because of the findings from a diagnostic p
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Provider Identification Number (PIN)
Category III Codes CPT
-99 - Multiple Modifiers
33. 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
Compression fracture
Carpals
Collagen
TRICARE
34. poisoning was inflicted by another person with intent to kill or injure
Assault
Unlisted Procedures Procedures
Ethmoid Bone
Personal Insurance
35. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.
Health Maintenance Organization (HMO)
Pre-determination
Greenstick
Unspecified nature
36. The skin and its accessory organs.Integument means covering. The skin covers over an area of 22 square feet ( an average adult). It is a complex system of specialized tissues containing glands - nerves and blood vessels. The main function of the skin
Disability insurance
The Integumentary System
Mutually Exclusive Edits
Carcinoma (Ca) in situ
37. 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.
Liability insurance
Chapters
Medicaid
Past - family and social history (PFSH)
38. When a group of employees and their dependents are insured under one (1) group policy issued to the employer. Generally - the employer pays the premium or a portion of the premium and the employee pays the difference. This all depends on the type of
Inferior nasal conchae
Group Insurance
Collagen
stand-alone codes
39. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
Group Provider Number
Health Insurance Portability and Accountability Act (HIPAA)
bullet (a
Ulcermembranes
40. Number assigned by the insurance company to a physician who renders services to patients.
Provider Identification Number (PIN)
MEDICAID COVERAGE
Mutually Exclusive Edits
MEDICARE Part C
41. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
Pre-determination
Coding
Primary malignancy
A plus sign (+)
42. The physician must obtain this number in order to practice within a state.
Accept assignment
State License Number
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Spinal/Vertebral Column
43. 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
Relative Value Payment Schedules Method
eponychium
co-payment
Categorically needy -MEDICAID
44. 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.
Keratin
Spinal/Vertebral Column
Medical Records
Remittance Advice
45. contains errors or omissions. Usually - these claims do not pass front-end edits. They are either processed manually for resolving problems - or rejected for payment.
ligaments
Carpals
Pre-authorization
Dirty claim
46. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
MEDICARE Part C
bullet (a
Mutually Exclusive Edits
Lipocyte
47. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.
Pre-certification
-26 - Professional Component
Carcinoma (Ca) in situ
Assault
48. Is a group of two or more physicians and non-physician practitioners legally organized in a partnership - professional corporation - foundation - not-for-profit corporation - faculty practice plan - or similar association.
Group practice
Comminuted fracture
eponychium
Unique Provider Identification Number (UPIN)
49. Discolored - flat lesion (freckles - tattoo marks)
Category I Codes CPT
stand-alone codes
Macule
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
50. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
Wheal
Retention of Medical Records
Unspecified nature
Evaluation and Management Review