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Test your basic knowledge |
Medical Billing And Coding Vocab
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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. 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.
MEDICARE Part A
Pre-determination
Advance Beneficiary Notice
Sesamoid bones
2. This is used to indicate that the service provided was required by a third-party payer - governmental - legislative - or regulatory body. This does not include second opinion requested by a patient - family member - or another physician.
Exclusions and Limitations
Non-covered benefit
-32 - Mandated Services
phalanges (phalanx.s)
3. Discolored - flat lesion (freckles - tattoo marks)
Full ROM
Parietal Bones
Macule
Gender rule
4. 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)
co-payment
ulna
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Hypertension Table
5. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Mutually Exclusive Edits
Inpatient
Subcategories
encounter form
6. 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.
Ischium
The Integumentary System
Categorically needy -MEDICAID
Advance Beneficiary Notice
7. 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:
Medical necessity
Sebaceous glands
Hypertension Table
MEDICARE Part D
8. Noninvasive - non-spreading - nonmalignant
Benign
Performing Provider Identification Number (PPIN)
Zygoma
Group practice
9. 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 A
History
Category III Codes CPT
HCPCS Level II codes (National Codes)
10. 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
Pelvis
Workers Compensation
Fee-for-Service
Mutually Exclusive Edits
11. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.
Medicare
ulna
Greenstick
Coding
12. 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
Uncertain behavior
Impetigo
Consultation
Preferred Provider plan
13. 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.
Evaluation and Management Review
Physician
MEDICARE Part D
TRICARE PLANS
14. This is used to indicate that the service provided was required by a third-party payer - governmental - legislative - or regulatory body. This does not include second opinion requested by a patient - family member - or another physician.
-32 - Mandated Services
Parietal Bones
Review of Systems (ROS)
Patient Confidentiality
15. The physician must obtain this number in order to practice within a state.
Commercial Carriers
Macule
State License Number
Category I Codes CPT
16. 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
Group practice
MEDICARE Part B
The Patient Care Partnership (Patient's Bill of Rights)
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
17. This is not specified as benign or malignant in the diagnosis or medical record.
-32 - Mandated Services
Unspecified (hypertension)
Retention of Medical Records
Medical necessity
18. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
Past - family and social history (PFSH)
The Good Samaritan Act
Collagen
Fiscal Intermediary
19. Are composed of three-digit codes representing a single disease or condition.
Add-on codes
Compliance Regulations
Categories
History of present illness (HPI)
20. Consists of the skull - rib cage - and spine
axial skeleton
Medically needy
ligaments
Macule
21. 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.
Add-on codes
Established Patient
Benign (hypertension)
lunula
22. Is a working diagnosis which is not yet established.
Suicide Attempt
Relative Value Payment Schedules Method
Qualified diagnosis
Established Patient
23. Forms the anterior part of the skull and the forehead
HCPCS Level II codes (National Codes)
Primary malignancy
Commercial Carriers
Frontal Bone
24. 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
Gender rule
Clean claim
Health Insurance Portability and Accountability Act (HIPAA)
Medicare
25. Codes from the CPT codebook are used to report services and procedures by physicians. It is published and updated annually by the American Medical Association (AMA) with a new one coming out each November and becoming effective on January 1st of the
The Current Procedural Terminology (CPT)
Modifiers
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
MEDICARE Part D
26. 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
Sesamoid bones
Sebaceous glands
Medicare
Non-covered benefit
27. includes the shoulder girdle which is made up of the scapula - clavicle and upper extremities. The scapula - or shoulder blades are flat bones that help support the arms. The clavicle - or collarbone - is curved horizontal bones that attach to the u
Health Care Financing Administration Common Procedure Coding System
upper appendicular skeleton
-99 - Multiple Modifiers
Malignant
28. 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.
Pre-determination
Limited ROM
Parietal Bones
29. 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.
The Current Procedural Terminology (CPT)
Pubic bone
Medical Records
Personal Insurance
30. 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.
Fiscal Intermediary
Clean claim
Medical Records
Frontal Bone
31. 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
appendicular skeleton .
Sebaceous glands
eponychium
32. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Group practice
Wheal
Patient Confidentiality
Coding
33. Mild or controlled hypertension and no damage to the vascular system or organs.
Performing Provider Identification Number (PPIN)
Multigravida
Benign (hypertension)
Lipocyte
34. 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.
Greenstick
Physician
Gangrene
Mandible
35. Law passed by the federal government to prosecute cases of Medicaid fraud.
MEDICARE Part D
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Civil Monetary Penalties Law (CMPL)
Group Insurance
36. Numbers 1-7 - attach directly to the sternum in the front of the body.
Impacted
true ribs
Pre-certification
Established Patient
37. is defined as one who has not received any medical services within the last three years.
New Patient
Collagen
itemized statement
Health Care Financing Administration Common Procedure Coding System
38. forms the two lower sides of the cranium.
Temporal Bone
Peer Review Organization (PRO)
State License Number
Pre-certification
39. Represents a new procedure or service code added since the previous edition of the manual.
Pelvis
Limited ROM
bullet (a
Section 3 Index to External Causes of Injury (E codes)
40. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
Rib Cage
Sections
MEDICARE Part B
Sub classification
41. The plan of the parent whose birthday falls earlier in the year (month and day - not year) is primary to that whose birthday falls later in the year. If both parents have the same birthday - then the plan of the parent who has had the longest coverag
Birthday rule
Ulcermembranes
Health Insurance Portability and Accountability Act (HIPAA)
Humerus
42. 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
Surgical Package
Health Care Financing Administration Common Procedure Coding System
History
Vomer
43. 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.'
Full ROM
Medical necessity
Sphenoid Bones
Complicated
44. male of household is primary payer
Qualified diagnosis
Gender rule
upper appendicular skeleton
Employer Liability
45. Poisoning cannot be determined whether intentional or accidental.
Undetermined
Wheal
History
Abuse
46. Describes the services billed and includes a breakdown of how the payment is determined
Tabular List (Volume 1)...
-51 - Multiple Procedures
Non-covered benefit
Explanation of Benefits (EOB)
47. This modifier is used to report a procedure or service that has more than one Modifier but the third-party payer does not allow the addition of multiple modifiers to the code. Modifier -99 is attached to the procedure code and the multiple Modifiers
Hairline
Ulcermembranes
-99 - Multiple Modifiers
The Good Samaritan Act
48. 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
State License Number
The Current Procedural Terminology (CPT)
Group Insurance
Musculoskeletal System
49. paired bones at the corner of each eye that cradle the tear ducts.
Humerus
Lacrimal bones
Physician
Fraud
50. Prescription Drugs The Medicare Prescription Drug - Improvement - and Modernization Act enacted in December 2003 and began implementation in January 2006 where Medicare beneficiaries can enroll in the Medicare prescription drug plan. The beneficiari
Clean claim
MEDICARE Part D
sprain
Lipocyte