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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. forms the roof of the nasal cavity.
Explanation of Benefits (EOB)
Point-of-Service plan (POS)
Categories
Ethmoid Bone
2. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
The St. Anthony Relative Value for Physicians (RVP)
MEDICARE Part D
Rib Cage
Health Insurance Portability and Accountability Act (HIPAA)
3. Are composed of three-digit codes representing a single disease or condition.
Mutually Exclusive Edits
Contracted Rates with MCOs
Lacrimal bones
Categories
4. male of household is primary payer
Gender rule
Disability insurance
Chief complaint (CC)
False Claims Act (FCA)
5. This is the inventory of the constitutional symptoms regarding the various body systems.
Review of Systems (ROS)
lunula
eponychium
phalanges (phalanx.s)
6. 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
The Patient Care Partnership (Patient's Bill of Rights)
Exclusions and Limitations
Medicare Claim Status
7. Consists of the skull - rib cage - and spine
Health Maintenance Organization (HMO)
Mandible
Coordination of Benefits (COB)
axial skeleton
8. 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.
Undetermined
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
essential modifiers
Sections
9. Groove or crack like sore
Performing Provider Identification Number (PPIN)
Occipital Bone
Fissure
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
10. are small with irregular shapes. They are found in the wrist and ankle.
Short bones
Melanin
The Integumentary System
Neoplasm Table
11. 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
Chief complaint (CC)
Sphenoid Bones
nonessential modifiers
There are three layers to the skin
12. Most billing-related cases are based on HIPAA and False Claims Act.
Suicide Attempt
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Compliance Regulations
Polyp
13. poisoning was inflicted by another person with intent to kill or injure
Malignant
Electronic Claim
Assault
Collagen
14. The moon like white area at the base of the nail.
lunula
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Gender rule
Patient Confidentiality
15. Represent changes in the text or definition between the triangles.
Blue Cross/Blue Shield Plans
Alphabetic Index (Volume 2)
Advance Beneficiary Notice
Two triangular symbols (a
16. 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
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Malignant
The Current Procedural Terminology (CPT)
Occipital Bone
17. 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.
Carpals
co-payment
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Greenstick
18. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.
Employee Liability
Fee Schedule
Salter-Harris
Primary malignancy
19. 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.
Advance Beneficiary Notice
Physician
Accept assignment
Medical necessity
20. uncertain whether benign or malignant; borderline malignancy
The St. Anthony Relative Value for Physicians (RVP)
MEDICARE Part A
Uncertain behavior
Alopecia
21. Are supplemental codes used for performance measurements. Although these codes are intended to facilitate data collection about the quality of care - their use is optional. Category II codes are published twice a year: January 1st and July 1st.
Category II Codes CPT
Multigravida
Fee Schedule
Carpals
22. Is when two insurance companies work together to coordinate payment of the benefits.
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Section 3 Index to External Causes of Injury (E codes)
Coordination of Benefits (COB)
Social Security Number
23. Are conditions - situations - and services not covered by the insurance carrier.
Physician
History of present illness (HPI)
Exclusions and Limitations
Unlisted Procedures Procedures
24. This is a set of information the physician gathers from the patient regarding the following:
The Good Samaritan Act
Group practice
History
encounter form
25. 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
Category III Codes CPT
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
triangle (a
Modifiers
26. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
sebaceous(oil) glands and the suddoriferous (sweat) glands
Parietal Bones
essential modifiers
Medically needy
27. Poisoning cannot be determined whether intentional or accidental.
Nonparticipating physician
Location Methods
Undetermined
Past - family and social history (PFSH)
28. 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.
New Patient
ulna
Modifiers
Health Maintenance Organization (HMO)
29. Is the type of plan a patient may have where they can see providers outside their plan. The patient is responsible to pay the higher portion of the fee.
Preferred Provider plan
Pubic bone
Salter-Harris
Invalid claim
30. Eccrine sweat glands are the most common and the apocrine sweat glands that secrete an odorless sweat.
Polyp
Albino
History of present illness (HPI)
There are two types of sweat glands
31. This modifier is used to explain that the procedure or service done during a postoperative period was planned at the time of the original procedure. This is also used if a therapeutic procedure is performed because of the findings from a diagnostic p
co-payment
Personal Insurance
Primary malignancy
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
32. Represents a new procedure or service code added since the previous edition of the manual.
Preferred Provider Organization (PPO)
Undetermined
bullet (a
Suicide Attempt
33. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
Zygoma
Compliance Regulations
Wheal
Category II Codes CPT
34. 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
ulna
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
nonessential modifiers
TRICARE
35. major skin pigment
Melanin
-51 - Multiple Procedures
Exclusions and Limitations
Chapters
36. 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.
Comminuted fracture
Fraud
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Employer Liability
37. 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
Wheal
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
ligaments
Benign
38. Mild or controlled hypertension and no damage to the vascular system or organs.
-99 - Multiple Modifiers
Benign (hypertension)
The Universal Claim Form
Mandible
39. Is made up of the shoulder - collar - pelvic and arms and legs
appendicular skeleton .
Suicide Attempt
Macule
Commercial Carriers
40. most synarthroses are immovable joints held together by fibrous tissue.
CPT SECTIONS.
Complicated
No ROM
CPT SECTIONS.
41. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
Two triangular symbols (a
itemized statement
Wheal
The Good Samaritan Act
42. 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.
Unlisted Procedures Procedures
HCPCS Level I codes
Medical Records
Palatine bones
43. 'Errors and omissions insurance' is protection against loss of monies caused by failure through error or unintentional omission on the part of the individual or service submitting the insurance claim. Some physicians' contract with a billing service
MEDICARE Part B
Employee Liability
Nonparticipating physician
Chief complaint (CC)
44. 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
The Universal Claim Form
MEDICAID COVERAGE
Nodule
Chapters
45. 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
co-payment
History
itemized statement
Coinsurance
46. Pre-determined set of benefits covered under one set annual fee.
Medicare
Neoplasm Table
Pre-paid Health Plan
HCPCS Level I codes
47. 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
Sub classification
Medicare
Compression fracture
CPT SECTIONS.
48. Is a fee that is charged for each procedure or service performed by the physician. This fee is obtained from a fee schedule - which is a list of charges or allowance that have accepted for specific medical services. The system in which fee schedules
History of present illness (HPI)
The Current Procedural Terminology (CPT)
Established patient
Fee-for-Service
49. 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
Patient Confidentiality
-90 - Reference (Outside) Laboratory
The Integumentary System
50. This is any procedure or service reported on the insurance claim that is not listed in the payer's master benefit list. This will result in the denial of the claim. Providers may be able to recover the charges from the patient.
Add-on codes
Non-covered benefit
Ischium
Section 3 Index to External Causes of Injury (E codes)