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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. Superior and widest bone
Pelvis
Rejected claim
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Gangrene
2. open sore on the skin or mucous
Categorically needy -MEDICAID
Ethmoid Bone
Ulcermembranes
Pre-paid Health Plan
3. The cuticle at the lower part of the nail and this is sometimes referred to as the
Eligibility
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Section 3 Index to External Causes of Injury (E codes)
eponychium
4. major skin pigment
Assault
Gangrene
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Melanin
5. 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
Eligibility
Peer Review Organization (PRO)
Sebaceous glands
Malignant
6. The moon like white area at the base of the nail.
Liability insurance
There are three layers to the skin
lunula
-26 - Professional Component
7. Poisoning was due to: Accidental overdose; Wrong substance taken; Accidents in use of drugs and biologicals; External causes of poisonings classifiable to 980-989 Therapeutic Use: instances when a correct substance properly taken is the cause of adve
There are three layers to the skin
Participating physician
Mutually Exclusive Edits
Accident
8. Poisoning cannot be determined whether intentional or accidental.
Established Patient
Alopecia
Undetermined
Nonparticipating physician
9. 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
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Past - family and social history (PFSH)
-32 - Mandated Services
Group practice
10. Is a percentage of the cost of covered services that a policyholder or a secondary insurance pays. A common payment percentage for coinsurance is 80/20 which indicates that 20% is the coinsurance for which the beneficiary or secondary insurance is re
Accident
Coinsurance
Humerus
Performing Provider Identification Number (PPIN)
11. 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..
Maxilla
History of present illness (HPI)
TRICARE
Musculoskeletal System
12. 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.
There are three layers to the skin
The Good Samaritan Act
Outpatient
phalanges (phalanx.s)
13. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
Deductible
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Carcinoma (Ca) in situ
Liability insurance
14. Is one who has no contract with the health insurance plan.
Assault
Explanation of Benefits (EOB)
Nonparticipating physician
Exclusions and Limitations
15. Eccrine sweat glands are the most common and the apocrine sweat glands that secrete an odorless sweat.
Dirty claim
There are two types of sweat glands
Fraud
ligaments
16. Forms the sides of the cranium
Parietal Bones
MEDICARE Part B
Frontal Bone
Subcategories
17. 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.
Inferior nasal conchae
Polyp
Modifiers
Radius
18. Law passed by the federal government to prosecute cases of Medicaid fraud.
Civil Monetary Penalties Law (CMPL)
Collagen
National Correct Coding Initiative (NCCI)
Pelvis
19. Structural protein found in the skin and connective tissue
Group practice
Neoplasm Table
Collagen
ulna
20. 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
Outpatient
Fiscal Intermediary
Suicide Attempt
Workers Compensation
21. .. lower jaw bone.
Gangrene
Abuse
Mandible
New patient
22. A pregnant woman who has had at least one previous pregnancy.
Musculoskeletal System
encounter form
Malignant
Multigravida
23. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
Limited ROM
Invalid claim
eponychium
Deductible
24. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.
Peer Review Organization (PRO)
Civil Monetary Penalties Law (CMPL)
Subcategories
Participating physician
25. Deficient in pigment (melanin)
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
TRICARE PLANS
There are two types of sweat glands
Albino
26. 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
sprain
Pre-paid Health Plan
MEDICAID COVERAGE
27. This is the traditional method used by providers for submission of charges to insurance companies. The most commonly used form is the CMS-1500. Few plans still accept the physician's encounter form or superbill and Medicare will only accept claims on
Paper Claim
Performing Provider Identification Number (PPIN)
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
New Patient
28. 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.'
Suicide Attempt
Medical necessity
Disability insurance
New Patient
29. 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
Impetigo
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
MEDICARE Part A
Advance Beneficiary Notice
30. 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.
Established patient
Physician
Retention of Medical Records
Suicide Attempt
31. is defined as one who has not received any medical services within the last three years.
Zygoma
Pathologic
New Patient
Non-covered benefit
32. These parenthetic terms are called because their presence or absence does not have an effect on the selection of the code listed for the main term.
False ribs
nonessential modifiers
Chief complaint
Pathologic
33. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Medicare
circle with a line through it)
Employer Identification Number (EIN)
Personal Insurance
34. Is the upper arm bone.
MEDICARE Part D
Mandible
Humerus
Hypertension Table
35. 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.
Lacrimal bones
Polyp
Group Provider Number
Occipital Bone
36. The bone is broken and pierces an internal organ
National Correct Coding Initiative (NCCI)
Pelvis
Complicated
Benign
37. represents Exemption from the use of modifier -51
Health practitioner
Personal Insurance
circle with a line through it)
False ribs
38. Federal law that prohibits submitting a fraudulent claim or making a false statement or representation in connection with a claim. It also protects and rewards persons involved in whistle-blower cases.
true ribs
Pre-paid Health Plan
False Claims Act (FCA)
Primary malignancy
39. solid - round or oval elevated lesion more than 1 cm in diameter
Reasons for Documentation
ulna
Chapters
Nodule
40. 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
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
MEDICARE Part B
The Universal Claim Form
essential modifiers
41. This is attached to the code of the E/M service provided to a patient during the postoperative period to indicate that that service is not part of the postoperative care which is usually part of a package of services of the surgery performed. Major s
Neoplasm Table
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Fissure
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
42. 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
essential modifiers
Impetigo
Subcategories
Mandible
43. Deficient in pigment (melanin)
circle with a line through it)
Medicaid
Coordination of Benefits (COB)
Albino
44. The bones are connected to one another by fibrous bands of tissue . Muscles are attached to the bone by tendons. The fibrous covering of the muscles is called the fascia
Full ROM
ligaments
MEDICARE Part A
Flat bones
45. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
Collagen
Long bones
Retention of Medical Records
Patient Confidentiality
46. 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.
Deductible
Medical Records
Indemnity Insurance
Assault
47. 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
Paper Claim
Comminuted fracture
Evaluation and Management Review
stand-alone codes
48. forms the back of the skull. There is a large hole at the ventral surface in this bone - called the foramen magnum - which allows the brain communication with the spinal cord
nonessential modifiers
Clean claim
Occipital Bone
Review of Systems (ROS)
49. Cheekbone
Zygoma
Frontal Bone
-51 - Multiple Procedures
Gangrene
50. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.
Peer Review Organization (PRO)
Hairline
Group Provider Number
sprain