SUBJECTS
|
BROWSE
|
CAREER CENTER
|
POPULAR
|
JOIN
|
LOGIN
Business Skills
|
Soft Skills
|
Basic Literacy
|
Certifications
About
|
Help
|
Privacy
|
Terms
|
Email
Search
Test your basic knowledge |
Medical Billing And Coding Vocab
Start Test
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. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the
MEDICARE Part A
Vomer
Neoplasm Table
Fraud
2. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
Fee Schedule
Two triangular symbols (a
Rib Cage
Nonparticipating physician
3. Groove or crack like sore
Gender rule
nonessential modifiers
Provider Identification Number (PIN)
Fissure
4. 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.
encounter form
Short bones
Retention of Medical Records
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
5. Most billing-related cases are based on HIPAA and False Claims Act.
Disability insurance
Compliance Regulations
Two triangular symbols (a
Performing Provider Identification Number (PPIN)
6. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
premium
The Good Samaritan Act
Health Insurance Portability and Accountability Act (HIPAA)
Pre-determination
7. consists of 17 chapters based on either body system or cause or type of disease. The codes range from 001-999.
Surgical Package
Spinal/Vertebral Column
Tabular List (Volume 1)...
-32 - Mandated Services
8. Absence of hair from areas where it normally grows
HCPCS Level II codes (National Codes)
History
Alopecia
Preferred Provider Organization (PPO)
9. Are supplementary classification codes used to describe the reason or external cause of injury - poisoning and other adverse effects. These codes can be found in both Volumes I and II. E codes are used to classify environmental events - circumstances
Ischium
Short bones
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Blue Cross/Blue Shield Plans
10. make up part of the roof of the mouth
Chief complaint
Social Security Number
Inferior nasal conchae
Palatine bones
11. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
Pubic bone
Malignant
Mutually Exclusive Edits
Spinal/Vertebral Column
12. is one who has not received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years.
New patient
Mandible
Modifiers
There are three layers to the skin
13. most synarthroses are immovable joints held together by fibrous tissue.
No ROM
Patient Confidentiality
Colles
Chief complaint (CC)
14. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Mutually Exclusive Edits
Birthday rule
Hypertension Table
sprain
15. Is defined as someone who has received medical services with in the last 3 years from the physician or another physician of the same specialty who belongs to the same group practice.
Established Patient
History of present illness (HPI)
Macule
Deductible
16. Deficient in pigment (melanin)
Advance Beneficiary Notice
Albino
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Surgical Package
17. 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
Medigap (Medicare Supplemental Insurance)
Eligibility
The Universal Claim Form
Group practice
18. 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.
Medicare
Fraud
nonessential modifiers
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
19. is basically the same as HMO in the sense that the health care provider enters into contract with the MCOs to render services to the beneficiaries. However - PPO's charge a higher premium than HMO's in exchange for more flexibility and more options
The Current Procedural Terminology (CPT)
The Universal Claim Form
Fiscal Intermediary
Preferred Provider Organization (PPO)
20. 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'.
Pre-authorization
Coordination of Benefits (COB)
Review of Systems (ROS)
Limited ROM
21. 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
Established patient
nonessential modifiers
Fiscal Intermediary
22. Upper jaw bone
circle with a line through it)
Nonparticipating physician
Maxilla
Performing Provider Identification Number (PPIN)
23. male of household is primary payer
triangle (a
Eligibility
Category II Codes CPT
Gender rule
24. 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
TRICARE PLANS
Evaluation and Management Review
Carpals
Clean claim
25. - 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
Invalid claim
Explanation of Benefits (EOB)
Medigap (Medicare Supplemental Insurance)
axial skeleton
26. 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
upper appendicular skeleton
Ischium
Hairline
Palatine bones
27. represents Exemption from the use of modifier -51
Paper Claim
Non-covered benefit
Accident
circle with a line through it)
28. Are a group of independently licensed local companies - usually nonprofit that contracts with physicians and other health entities to provide services to their insured companies and individuals. Most BC/BS plans offer HMO's - PPO's and POS plans. Blu
Add-on codes
Blue Cross/Blue Shield Plans
circle with a line through it)
Complicated
29. Is the upper arm bone.
Medically needy
Humerus
Limited ROM
Suicide Attempt
30. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
False Claims Act (FCA)
Electronic Claim
Health Insurance Portability and Accountability Act (HIPAA)
Maxilla
31. Represents a change in the code description since the last edition. The change may be minor or significant and it could be an addition - deletion or revision.
triangle (a
Radius
Ulcermembranes
Indemnity Insurance
32. 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
Indemnity Insurance
Chief complaint
Employer Liability
There are three layers to the skin
33. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Uncertain behavior
Complicated
Capitated Rates
Chief complaint
34. is defined as reimbursement for income lost as a result of a temporary or permanent illness or injury. When patients are treated for disability diagnoses and other medical problems - separate patient records must be maintained. Disability insurance
CPT SECTIONS.
History
Musculoskeletal System
Disability insurance
35. 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.
Category III Codes CPT
False Claims Act (FCA)
-51 - Multiple Procedures
Fissure
36. the bone is broken and the ends are driven into each other.
Reasons for Documentation
Impacted
Section 3 Index to External Causes of Injury (E codes)
Contracted Rates with MCOs
37. 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
-26 - Professional Component
Fee-for-Service
Add-on codes
38. most synarthroses are immovable joints held together by fibrous tissue.
axial skeleton
No ROM
Clearinghouse
Radius
39. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
Rejected claim
Medicare
Primary malignancy
Physician
40. Small collection of clear fluid;blister
Vesicle
Mutually Exclusive Edits
MEDICAID COVERAGE
Albino
41.
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
phalanges (phalanx.s)
Unauthorized benefit
Advance Beneficiary Notice
42. 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
Medical Records
Group practice
nonessential modifiers
Occipital Bone
43. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Ethmoid Bone
Vesicle
ulna
Accept assignment
44. The Usual - Customary - and Reasonable: The UCR method is used mostly in reference to fee-for-service reimbursement. To arrive at a payment amount for a claim - the carrier compares: The physician's most frequent charge for a given service (the usual
New Patient
Fee Schedule
Two triangular symbols (a
Established patient
45. major skin pigment
Two triangular symbols (a
Peer Review Organization (PRO)
Melanin
Advance Beneficiary Notice
46. is defined as one who has not received any medical services within the last three years.
Disability insurance
Colles
New Patient
Reasons for Documentation
47. Created the Health Care Fraud and Abuse Control Program enacted to check for fraud and abuse in the Medicare and Medicaid programs - and private payers.
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Undetermined
ligaments
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
48. Is the cost of insurance coverage paid annually - semi-annually or monthly to keep a policy in effect.
premium
Carcinoma (Ca) in situ
Health Insurance Portability and Accountability Act (HIPAA)
Musculoskeletal System
49. Forms the sides of the cranium
Medigap (Medicare Supplemental Insurance)
Add-on codes
Parietal Bones
Medical Records
50. This modifier is used when the same procedure is performed on a mirror-image part of the body..
Suicide Attempt
-50 - Bilateral Procedure
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Category I Codes CPT