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Test your basic knowledge |
Medical Billing And Coding Vocab
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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. 'Errors and omissions insurance' is protection against loss of monies caused by failure through error or unintentional omission on the part of the individual or service submitting the insurance claim. Some physicians' contract with a billing service
Employee Liability
Coinsurance
upper appendicular skeleton
triangle (a
2. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
Deductible
A plus sign (+)
Pre-paid Health Plan
upper appendicular skeleton
3. death of tissue associated with loss of blood supply
Fiscal Intermediary
Outpatient
Pubic bone
Gangrene
4. Is a term used when a patient is admitted to the hospital with the expectation that the patient will stay for a period of 24 hours or more.
Sphenoid Bones
Inpatient
Albino
Exclusions and Limitations
5. 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
Patient Confidentiality
Chief complaint (CC)
HCPCS Level I codes
triangle (a
6. The CPT Index is arranged in alphabetical order by main terms which are further divided by subterms. There are five location methods: 1. Service or Procedure 2. Anatomic site 3. Condition or Disease 4. Synonym/Eponym 5. Abbreviation
Location Methods
Accident
Past - family and social history (PFSH)
New Patient
7. 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.
Nodule
phalanges (phalanx.s)
Primary malignancy
Employer Liability
8. Is the lower medial arm bone.
ulna
Primary malignancy
Social Security Number
Advance Beneficiary Notice
9. Is the cost of insurance coverage paid annually - semi-annually or monthly to keep a policy in effect.
Preferred Provider Organization (PPO)
Malignant
premium
Indemnity Insurance
10. 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
Outpatient
eponychium
Contracted Rates with MCOs
Sesamoid bones
11. Number assigned to the physician by Medicare program.
Coinsurance
The Good Samaritan Act
Group practice
Unique Provider Identification Number (UPIN)
12. The bone is broken and pierces an internal organ
HCPCS Level I codes
Categories
Complicated
Rejected claim
13. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
History
-99 - Multiple Modifiers
Chapters
Medically needy
14. Is an entity that receives transmissions of claims from physicians' offices - separates the claims by carriers and performs software edits on each claim to check for errors. Once this process is complete - the claim is then sent to the proper insuran
Clearinghouse
circle with a line through it)
Reasons for Documentation
-26 - Professional Component
15. A physician has a separate PPIN for each group office/clinic in which he or she practices. In the Medicare program - in addition to a group number - each member of a group is issued an 8-character performing provider identification number.
The Universal Claim Form
Performing Provider Identification Number (PPIN)
Benign
Pre-certification
16. The epidermis - the dermis - and the subcutaneous layer. The epidermis is a thin - cellular membrane layer that contains keratin. The dermis is a dense - fibrous - connective tissue that contains collagen. The subcutaneous layer is a thicker and fatt
Chief complaint
There are three layers to the skin
Contracted Rates with MCOs
Patient Confidentiality
17. 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
Employer Identification Number (EIN)
Modifiers
Evaluation and Management Review
18. Represent changes in the text or definition between the triangles.
Electronic Claim
Review of Systems (ROS)
Unlisted Procedures Procedures
Two triangular symbols (a
19. the bone is crushed and or shattered.
Comminuted fracture
phalanges (phalanx.s)
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
itemized statement
20. 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
Medicare
Performing Provider Identification Number (PPIN)
-51 - Multiple Procedures
MEDICARE Part D
21. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
State License Number
Radius
Commercial Carriers
Malignant
22. This modifier is used to indicate that the procedure or service provided during the postoperative period was not associated with the initial procedure. Payment for the full fee of the subsequent procedure is requested and a new global period starts.
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Sphenoid Bones
Retention of Medical Records
Categories
23. 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.
Collagen
Capitated Rates
Physician
Abuse
24. Number assigned by the insurance company to a physician who renders services to patients.
Dirty claim
premium
Abuse
Provider Identification Number (PIN)
25. make up part of the roof of the mouth
Chief complaint (CC)
Palatine bones
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Birthday rule
26. Forms the sides of the cranium
Coding
History of present illness (HPI)
ulna
Parietal Bones
27. Deficient in pigment (melanin)
Past - family and social history (PFSH)
Health Care Financing Administration Common Procedure Coding System
Group Provider Number
Albino
28. Under this schedule - a procedure's relative value is the sum total of three elements: Work: represents the amount of time - intensity of effort - and medical skill required of the physician. Overhead: practice costs related to the performing of the
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29. There are also terms indented two spaces to the right below the main term called subterms. These subterms are because they have bearing in the selection of the right code. Everything in the Index is listed by condition - that is - diagnosis - signs -
essential modifiers
Civil Monetary Penalties Law (CMPL)
-51 - Multiple Procedures
Established patient
30. Are small - rounded bones that resemble a sesame seed. They are found near joints and increase the efficiency of muscles near a joint. An example of sesamoid bone is the knee cap.
Sebaceous glands
Sub classification
Sesamoid bones
There are three layers to the skin
31. .. lower jaw bone.
Employer Liability
Mandible
Fiscal Intermediary
Pre-certification
32. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
Primary malignancy
Carcinoma (Ca) in situ
Pubic bone
eponychium
33. Is a cost-sharing requirement for the insured to pay at the time of service. This amount is usually a specific dollar amount (e.g.. $15 - $20 - $25)
TRICARE PLANS
co-payment
Past - family and social history (PFSH)
Flat bones
34. 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.
Commercial Carriers
Keratin
Dirty claim
MEDICARE Part D
35. The physician must obtain this number in order to practice within a state.
State License Number
Pre-certification
Carcinoma (Ca) in situ
Participating physician
36. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
Clean claim
Fiscal Intermediary
Health practitioner
triangle (a
37. poisoning was inflicted by another person with intent to kill or injure
triangle (a
Assault
Retention of Medical Records
Employee Liability
38. 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.
MEDICARE Part D
Physician
Category III Codes CPT
Gangrene
39. A minor fracture appears as a thin line on x-ray and may not extend completely through the bone.
Hairline
MEDICAID COVERAGE
bullet (a
Categories
40. This is the inventory of the constitutional symptoms regarding the various body systems.
eponychium
Blue Cross/Blue Shield Plans
Humerus
Review of Systems (ROS)
41. This is also known as fee-for-service. Under this plan - the services that are paid for are listed in the policy and payments are based on the fees physicians charge for the service. Each year - the beneficiary must meet a deductible - after which -
essential modifiers
Undetermined
Indemnity Insurance
Modifiers
42. 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..
Colles
Participating physician
No ROM
Musculoskeletal System
43. Was created to provide medical benefits to spouses and children of veterans with total - permanent service related disabilities or for surviving spouses and children of a veteran who died as a result of service-related disability. It is a service ben
Location Methods
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Physician
Pathologic
44. 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
Workers Compensation
Humerus
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
axial skeleton
45. Is a service performed by a physician whose opinion or advice is requested by another physician in the evaluation or treatment of a patient's illness or suspected problem. The consultant does not assume responsibility for the patient's care and must
Retention of Medical Records
Primary malignancy
Consultation
Carpals
46. 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..
Medical necessity
The Good Samaritan Act
Musculoskeletal System
MEDICARE Part B
47. Represent changes in the text or definition between the triangles.
sprain
Musculoskeletal System
The Good Samaritan Act
Two triangular symbols (a
48. 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
sebaceous(oil) glands and the suddoriferous (sweat) glands
Collagen
Wheal
Electronic Claim
49. 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.
Pathologic
Pelvis
Uncertain behavior
Medicare Claim Status
50. 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).
Provider Identification Number (PIN)
Sections
Sub classification
Review of Systems (ROS)