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Test your basic knowledge |
Medical Billing And Coding Vocab
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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. 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.
Past - family and social history (PFSH)
Group practice
Coordination of Benefits (COB)
Chief complaint
2. Was created to provide medical benefits to spouses and children of veterans with total - permanent service related disabilities or for surviving spouses and children of a veteran who died as a result of service-related disability. It is a service ben
Nodule
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
sebaceous(oil) glands and the suddoriferous (sweat) glands
Explanation of Benefits (EOB)
3. Families - pregnant women - and children ;Aid to Families with Dependent Children (AFDC)-related groups ;Non-AFDC pregnant women and children;Aged and disabled persons ;Supplemental Security Income (SSI)-related groups ;Qualified Medicare Beneficiari
Categorically needy -MEDICAID
Albino
Group Insurance
Mutually Exclusive Edits
4. Groove or crack like sore
Fissure
Palatine bones
true ribs
Explanation of Benefits (EOB)
5. is a federal program administered by state governments to provide medical assistance to the needy. Each state sets its own guidelines for eligibility and services - therefore benefits and coverage may vary widely from state to state.
Medicaid
Spinal/Vertebral Column
-90 - Reference (Outside) Laboratory
The Good Samaritan Act
6. Cheekbone
Zygoma
The Patient Care Partnership (Patient's Bill of Rights)
Pathologic
Sebaceous glands
7. A fracture of the epiphyseal plate in children.
appendicular skeleton .
Spinal/Vertebral Column
Salter-Harris
Section 3 Index to External Causes of Injury (E codes)
8. 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:
Location Methods
Hypertension Table
Abuse
Impacted
9. 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
Reasons for Documentation
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Performing Provider Identification Number (PPIN)
ligaments
10. forms the two lower sides of the cranium.
circle with a line through it)
Temporal Bone
Advance Beneficiary Notice
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
11. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body
Performing Provider Identification Number (PPIN)
Secondary malignancy
National Correct Coding Initiative (NCCI)
-99 - Multiple Modifiers
12. The bone is broken and pierces an internal organ
Unique Provider Identification Number (UPIN)
Established Patient
Complicated
-90 - Reference (Outside) Laboratory
13. 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.
bullet (a
Malignant
Modifiers
Past - family and social history (PFSH)
14. Are codes formulated thru the joint efforts of the CMS - the Health Insurance Association of America - and the Blue Cross and Blue Shield Association. Level II contains five position alpha-numeric codes for physician and non-physician services not fo
itemized statement
Pelvis
HCPCS Level II codes (National Codes)
Unauthorized benefit
15. Is a regionally managed healthcare program for active duty and retired members of the armed forces - their families - and survivors. It is a service benefit program and contains no premium. TRICARE is the new title for the CHAMPUS program (Civilian H
Blue Cross/Blue Shield Plans
Accident
Coding
TRICARE
16. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.
Pelvis
Benign
Palatine bones
Limited ROM
17. Is a managed care benefits plan that provides a wide range of medical services to individuals that have been enrolled into the program. It is generally the least costly but at the same time also the most restrictive. This plan uses a gatekeeper physi
Impacted
Fiscal Intermediary
Malignant
Health Maintenance Organization (HMO)
18. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.
Pre-certification
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Hypertension Table
Capitated Rates
19. 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
Uncertain behavior
The Integumentary System
Section 3 Index to External Causes of Injury (E codes)
20. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
TRICARE
Medicare Claim Status
Participating physician
Chief complaint
21. Number assigned to the physician by Medicare program.
Unique Provider Identification Number (UPIN)
Humerus
Fissure
-50 - Bilateral Procedure
22. This modifier is used to indicate that the procedure was done by an outside laboratory and not by the reporting facility or clinic.
History of present illness (HPI)
-90 - Reference (Outside) Laboratory
Accident
Civil Monetary Penalties Law (CMPL)
23. Is a working diagnosis which is not yet established.
Qualified diagnosis
Category III Codes CPT
Pre-paid Health Plan
sprain
24. Various terms are used to describe the state of submitted forms. The following are some of the terms that are typically used by insurance carriers.
Impacted
Medicare Claim Status
-90 - Reference (Outside) Laboratory
The Good Samaritan Act
25. 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
Pre-paid Health Plan
MEDICARE Part D
Workers Compensation
Hypertension Table
26. 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
Health practitioner
Humerus
Fee Schedule
Chief complaint (CC)
27. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.
bullet (a
Participating physician
triangle (a
appendicular skeleton .
28. Benign growth extending from the surface of the mucous membrane
co-payment
Section 3 Index to External Causes of Injury (E codes)
Polyp
National Correct Coding Initiative (NCCI)
29. A chronological account of the development of the complaint from the first sign or symptom that the patient experienced to the present
History of present illness (HPI)
Vesicle
Fissure
Mandible
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.
Abuse
Malignant
Radius
Medical Records
31. 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.
Advance Beneficiary Notice
Rib Cage
Unlisted Procedures Procedures
Category III Codes CPT
32. The break of the distal end of the radius at the epiphysis often occurs when the patient has attempted to break his or her fall.
Colles
Alopecia
MEDICAID COVERAGE
Social Security Number
33. are small with irregular shapes. They are found in the wrist and ankle.
Peer Review Organization (PRO)
Workers Compensation
Short bones
Paper Claim
34. 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
-51 - Multiple Procedures
CPT SECTIONS.
False ribs
Medically needy
35. requires investigation and needs further clarification.
False Claims Act (FCA)
Employee Liability
No ROM
Rejected claim
36. Most procedures have both professional (physician) and technical components. This modifier is attached to the procedure to indicate that the physician provided only the professional component.
-26 - Professional Component
Hypertension Table
Relative Value Payment Schedules Method
Pre-authorization
37. The fractured area of bone collapses on itself.
Non-covered benefit
Frontal Bone
Social Security Number
Compression fracture
38. Represents a new procedure or service code added since the previous edition of the manual.
bullet (a
Point-of-Service plan (POS)
Carpals
The Integumentary System
39. 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.
Compression fracture
-99 - Multiple Modifiers
Medically needy
Category III Codes CPT
40. Physicians are legally responsible for their own conduct and any actions of their employees (their designee) performed within the context of their employment. This is referred to as 'vicarious liability -' also known as 'respondent superior -' which
Employer Liability
Inferior nasal conchae
Coinsurance
Remittance Advice
41. 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
TRICARE PLANS
History of present illness (HPI)
Pre-certification
42. Is an electronic or paper-based report of payment sent by the payer to the provider.
Civil Monetary Penalties Law (CMPL)
Malignant
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Remittance Advice
43. Consists of the skull - rib cage - and spine
New Patient
Unlisted Procedures Procedures
axial skeleton
Long bones
44. 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.
Rejected claim
Non-covered benefit
Category II Codes CPT
-26 - Professional Component
45. Are the main division in the ICD-9-CM; they are divided into sections. e.g.. - 3. Endocrine - Nutritional and Metabolic Diseases - and Immunity Disorders (240-279).
Surgical Package
Chapters
Ischium
Employee Liability
46.
Multigravida
Clean claim
Pelvis
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
47. Is an entity that receives transmissions of claims from physicians' offices - separates the claims by carriers and performs software edits on each claim to check for errors. Once this process is complete - the claim is then sent to the proper insuran
Remittance Advice
Clearinghouse
Remittance Advice
Secondary malignancy
48. is a traumatic injury to a joint involving the soft tissue.
MEDICARE Part C
Categorically needy -MEDICAID
sprain
Employer Identification Number (EIN)
49. Typically not used on the claim form unless the provider does not have an EIN.
Clean claim
Paper Claim
Social Security Number
Occipital Bone
50. Is the upper arm bone.
Category II Codes CPT
Humerus
Inpatient
Invalid claim