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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. Families - pregnant women - and children ;Aid to Families with Dependent Children (AFDC)-related groups ;Non-AFDC pregnant women and children;Aged and disabled persons ;Supplemental Security Income (SSI)-related groups ;Qualified Medicare Beneficiari
Categorically needy -MEDICAID
Radius
Ethmoid Bone
Peer Review Organization (PRO)
2. This is not specified as benign or malignant in the diagnosis or medical record.
Primary malignancy
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Unspecified (hypertension)
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
3. 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.
Complicated
Carcinoma (Ca) in situ
Alphabetic Index (Volume 2)
Colles
4. The poisoning was self-inflicted.
encounter form
Outpatient
MEDICAID COVERAGE
Suicide Attempt
5. Noninvasive - non-spreading - nonmalignant
Carcinoma (Ca) in situ
Benign
Medicaid
HCPCS Level II codes (National Codes)
6. Poisoning cannot be determined whether intentional or accidental.
Section 3 Index to External Causes of Injury (E codes)
Liability insurance
-90 - Reference (Outside) Laboratory
Undetermined
7. 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
Suicide Attempt
Hairline
Employer Liability
8. 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.
The St. Anthony Relative Value for Physicians (RVP)
Medicaid
History of present illness (HPI)
Subcategories
9. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
Wheal
Assault
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Paper Claim
10. 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
Short bones
Location Methods
Sebaceous glands
Multigravida
11. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
triangle (a
Clearinghouse
Impetigo
Eligibility
12. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Accept assignment
The Good Samaritan Act
Participating physician
HCPCS Level II codes (National Codes)
13. Indicates add-on codes
Location Methods
Medicare
A plus sign (+)
Inpatient
14. 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 -
sebaceous(oil) glands and the suddoriferous (sweat) glands
Indemnity Insurance
Location Methods
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
15. Under capitation - the physician provides a full range of contracted services to covered patients for a fixed amount on a periodic basis. While guaranteed a fixed amount - the physician assumes the risk that the cost of providing the care to the pati
Palatine bones
Capitated Rates
Unspecified nature
MEDICARE Part A
16. open sore on the skin or mucous
Coinsurance
Medicare Claim Status
Ulcermembranes
Ischium
17. 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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18. A pregnant woman who has had at least one previous pregnancy.
Coordination of Benefits (COB)
Contracted Rates with MCOs
Spinal/Vertebral Column
Multigravida
19. Most billing-related cases are based on HIPAA and False Claims Act.
Compliance Regulations
Patient Confidentiality
sprain
Hypertension Table
20. death of tissue associated with loss of blood supply
Mutually Exclusive Edits
Tabular List (Volume 1)...
Gangrene
HCPCS Level II codes (National Codes)
21. Is a requirement for some health insurance plans to obtain permission for a service or procedure before it is done. It indicates that a specific procedure or service is deemed 'medically necessary'.
Fraud
encounter form
Pre-authorization
Participating physician
22. 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.
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
eponychium
Inpatient
New patient
23. 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
premium
Impacted
Commercial Carriers
Assault
24. To report a circumstance in which the physician returns to the operating room to address a complication stemming from the initial procedure - modifier -78 is attached to the subsequent procedure code.
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Coordination of Benefits (COB)
Commercial Carriers
Primary malignancy
25. Under capitation - the physician provides a full range of contracted services to covered patients for a fixed amount on a periodic basis. While guaranteed a fixed amount - the physician assumes the risk that the cost of providing the care to the pati
Capitated Rates
Ethmoid Bone
Performing Provider Identification Number (PPIN)
Flat bones
26. Mild or controlled hypertension and no damage to the vascular system or organs.
sebaceous(oil) glands and the suddoriferous (sweat) glands
Occipital Bone
Benign (hypertension)
Vesicle
27. the bone is broken and the ends are driven into each other.
Hypertension Table
HCPCS Level II codes (National Codes)
true ribs
Impacted
28. represents Exemption from the use of modifier -51
circle with a line through it)
Health Care Financing Administration Common Procedure Coding System
Pre-authorization
Spinal/Vertebral Column
29. 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.
Remittance Advice
Secondary malignancy
Employer Liability
Advance Beneficiary Notice
30. major skin pigment
Civil Monetary Penalties Law (CMPL)
Performing Provider Identification Number (PPIN)
Melanin
Review of Systems (ROS)
31. Is a statement of the patient's account history - showing dates of service - detailed charges - payments (i.e. deductibles and co-pays) - the date the insurance claim was submitted - applicable adjustments and account balance.
Radius
Unique Provider Identification Number (UPIN)
Evaluation and Management Review
itemized statement
32. 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
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Review of Systems (ROS)
Occipital Bone
Chief complaint
33. Consists of the skull - rib cage - and spine
Undetermined
Accept assignment
TRICARE PLANS
axial skeleton
34. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
Primary malignancy
Group Provider Number
Malignant
Outpatient
35. 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
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Ischium
Pre-determination
36. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
The Good Samaritan Act
Full ROM
Review of Systems (ROS)
CPT SECTIONS.
37. 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....
Malignant
Established patient
Preferred Provider Organization (PPO)
Employee Liability
38. Physicians agree to provide services at a discount of their usual fee in return for a pool of existing patients.
Preferred Provider Organization (PPO)
Group Insurance
Exclusions and Limitations
Contracted Rates with MCOs
39. Are the main division in the ICD-9-CM; they are divided into sections. e.g.. - 3. Endocrine - Nutritional and Metabolic Diseases - and Immunity Disorders (240-279).
Rib Cage
Accident
Relative Value Payment Schedules Method
Chapters
40. Law passed by the federal government to prosecute cases of Medicaid fraud.
Civil Monetary Penalties Law (CMPL)
Benign (hypertension)
History
TRICARE PLANS
41. In July 2001 - the Health Care Financing Administration (HCFA) became the Centers for Medicare & Medicaid Services (CMS) - and the universal claim form HCFA-1500 became the CMS-1500.Virtually all third-party payers will accept it - and Medicare requ
MEDICAID COVERAGE
The Universal Claim Form
Medicare Claim Status
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
42. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.
Patient Confidentiality
Hairline
Limited ROM
False ribs
43. 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..
Musculoskeletal System
Established Patient
National Correct Coding Initiative (NCCI)
History of present illness (HPI)
44. Number assigned to the physician by Medicare program.
Lipocyte
Advance Beneficiary Notice
Unique Provider Identification Number (UPIN)
Fee-for-Service
45. Are supplementary classification codes used to identify health care encounters that occur for reasons other than illness or injury or to identify patients whose illness is influenced by special circumstances or problems. The codes can be found in bot
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
MEDICARE Part A
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Outpatient
46. Used for procedures that is always performed during the same operative session as another surgery in addition to the primary service/procedure and is never performed separately.
New patient
The Patient Care Partnership (Patient's Bill of Rights)
Inpatient
Add-on codes
47. Is the qualifying factor or factors that must be met before a patient receives benefits.
History
Pathologic
Eligibility
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
48. 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
Chapters
Vesicle
triangle (a
49. 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
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
TRICARE PLANS
Medigap (Medicare Supplemental Insurance)
Mandible
50. Represents a new procedure or service code added since the previous edition of the manual.
Fissure
Non-covered benefit
Qualified diagnosis
bullet (a