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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. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
Category III Codes CPT
The Good Samaritan Act
Uncertain behavior
Pelvis
2. Contains complete - necessary information - but is incorrect or illogical in some way.
Impetigo
Invalid claim
Categories
Pathologic
3. This is the index for the E codes.It classifies - in alphabetical order - environmental events and other conditions as the cause of injury and other adverse effects.
Section 3 Index to External Causes of Injury (E codes)
Invalid claim
Participating physician
Participating physician
4. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.
Accident
Medicare Claim Status
Hairline
encounter form
5. 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
Contracted Rates with MCOs
Medicaid
Unauthorized benefit
6. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.
Section 3 Index to External Causes of Injury (E codes)
Participating physician
Pre-paid Health Plan
Eligibility
7. Produce secretions that allow the body to be moisturized or cooled.
Coordination of Benefits (COB)
bullet (a
sebaceous(oil) glands and the suddoriferous (sweat) glands
Blue Cross/Blue Shield Plans
8. Is a working diagnosis which is not yet established.
Qualified diagnosis
-99 - Multiple Modifiers
Medically needy
Physician
9. Structural protein found in the skin and connective tissue
Undetermined
Collagen
Temporal Bone
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
10. found in the Index under the main term 'Hypertension' - and it contains a list of conditions that are due to or associated with hypertension. The table classifies the conditions as:
Hypertension Table
co-payment
Civil Monetary Penalties Law (CMPL)
Subcategories
11. 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.
encounter form
Health Maintenance Organization (HMO)
Inpatient
axial skeleton
12. Consists of the skull - rib cage - and spine
Salter-Harris
Pre-certification
Short bones
axial skeleton
13. 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.
Suicide Attempt
Coordination of Benefits (COB)
nonessential modifiers
Group Provider Number
14. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
-26 - Professional Component
Medically needy
Health Care Financing Administration Common Procedure Coding System
bullet (a
15. most synarthroses are immovable joints held together by fibrous tissue.
Maxilla
Impacted
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
No ROM
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.
Medicare
Modifiers
The Universal Claim Form
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
17. 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
Workers Compensation
Humerus
Sebaceous glands
Undetermined
18. Any fracture occurring spontaneously as a result of disease.
Pathologic
False ribs
Health Insurance Portability and Accountability Act (HIPAA)
axial skeleton
19. 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
Neoplasm Table
Chief complaint (CC)
Fiscal Intermediary
History
20. Represent services and procedures widely used by many health care professionals in clinical practice in multiple locations and have been approved by the FDA.
Category I Codes CPT
premium
Social Security Number
appendicular skeleton .
21. Are composed of three-digit codes representing a single disease or condition.
Polyp
Hairline
Medicare Claim Status
Categories
22. Are composed of three-digit codes representing a single disease or condition.
Comminuted fracture
Workers Compensation
Categories
Sphenoid Bones
23. 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 -
Indemnity Insurance
Full ROM
Impetigo
The Good Samaritan Act
24. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
There are three layers to the skin
Compression fracture
Employer Identification Number (EIN)
Invalid claim
25. 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
Medicaid
ulna
MEDICARE Part B
Spinal/Vertebral Column
26. The fractured area of bone collapses on itself.
Compression fracture
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Categorically needy -MEDICAID
Categories
27. Is to determine the patient's benefits and the maximum dollar amount that the insurance company will pay. Often the first step of the insurance verification process - it is completed prior to the first visit.
Disability insurance
Temporal Bone
Pre-determination
Medical necessity
28. the bone is broken and the ends are driven into each other.
Compliance Regulations
Impacted
Invalid claim
nonessential modifiers
29. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
Disability insurance
ligaments
Rib Cage
Deductible
30. 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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31. Noninvasive - non-spreading - nonmalignant
The St. Anthony Relative Value for Physicians (RVP)
Benign (hypertension)
Benign
Pelvis
32. are small with irregular shapes. They are found in the wrist and ankle.
Short bones
Medical necessity
Sections
sebaceous(oil) glands and the suddoriferous (sweat) glands
33. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.
Greenstick
Limited ROM
The Universal Claim Form
Ethmoid Bone
34. Most billing-related cases are based on HIPAA and False Claims Act.
Category I Codes CPT
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Add-on codes
Compliance Regulations
35. A chronological account of the development of the complaint from the first sign or symptom that the patient experienced to the present
upper appendicular skeleton
Malignant
Alopecia
History of present illness (HPI)
36. 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
Commercial Carriers
Multigravida
Evaluation and Management Review
Review of Systems (ROS)
37. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Chief complaint
Lipocyte
MEDICAID COVERAGE
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
38. This is a set of information the physician gathers from the patient regarding the following:
History
Parietal Bones
Pubic bone
Ethmoid Bone
39. 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.
Lacrimal bones
Medical Records
Group Insurance
Compression fracture
40. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
Chief complaint (CC)
Carcinoma (Ca) in situ
The Patient Care Partnership (Patient's Bill of Rights)
Spinal/Vertebral Column
41. Unlike the RBRVS - the RVP has no geographic adjustment factor or individual RVU component to calculate. However - for each category of procedures - a separate conversion factor must be developed....
The St. Anthony Relative Value for Physicians (RVP)
Established patient
Uncertain behavior
Zygoma
42. A pregnant woman who has had at least one previous pregnancy.
Rejected claim
Multigravida
bullet (a
CPT SECTIONS.
43. The CPT manual is composed of eight sections. Each section begins with guidelines that provide specific coding rules for that section. Guidelines at the beginning of the section are applicable to all codes in the section - while notes that pertain t
CPT SECTIONS.
False Claims Act (FCA)
Health Care Financing Administration Common Procedure Coding System
The Integumentary System
44. 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
Invalid claim
Gender rule
TRICARE PLANS
Uncertain behavior
45. This is the inventory of the constitutional symptoms regarding the various body systems.
Preferred Provider Organization (PPO)
Categorically needy -MEDICAID
Review of Systems (ROS)
The Patient Care Partnership (Patient's Bill of Rights)
46. This is not specified as benign or malignant in the diagnosis or medical record.
Fee Schedule
Gangrene
Palatine bones
Unspecified (hypertension)
47. 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.
Unauthorized benefit
Sesamoid bones
sebaceous(oil) glands and the suddoriferous (sweat) glands
-32 - Mandated Services
48. Groove or crack like sore
Unique Provider Identification Number (UPIN)
The Current Procedural Terminology (CPT)
Fissure
eponychium
49. - To pay for medical services and items that Medicare does not cover and Medicare's coinsurance and deductibles - beneficiaries may purchase a supplemental insurance. Medigap is a private insurance designed to help pay for those amounts that are typ
Undetermined
Sesamoid bones
Medigap (Medicare Supplemental Insurance)
Performing Provider Identification Number (PPIN)
50. Represents a new procedure or service code added since the previous edition of the manual.
Medicare
bullet (a
Unspecified nature
Tabular List (Volume 1)...