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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.
If you are not ready to take this test, you can
study here
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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. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
Evaluation and Management Review
Assault
Flat bones
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
2. 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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3. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
MEDICARE Part D
The Good Samaritan Act
appendicular skeleton .
Point-of-Service plan (POS)
4. 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.
There are two types of sweat glands
Fiscal Intermediary
Category III Codes CPT
sprain
5. A physician has a separate PPIN for each group office/clinic in which he or she practices. In the Medicare program - in addition to a group number - each member of a group is issued an 8-character performing provider identification number.
Performing Provider Identification Number (PPIN)
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
State License Number
Group practice
6. A pregnant woman who has had at least one previous pregnancy.
Tabular List (Volume 1)...
Peer Review Organization (PRO)
Medigap (Medicare Supplemental Insurance)
Multigravida
7. Includes - but is not limited to - physician assistant - certified nurse-midwife - qualified psychologist - nurse practitioner - clinical social worker - physical therapist - occupational therapist - respiratory therapist - certified registered nurse
Inferior nasal conchae
Health practitioner
State License Number
Vomer
8. Under capitation - the physician provides a full range of contracted services to covered patients for a fixed amount on a periodic basis. While guaranteed a fixed amount - the physician assumes the risk that the cost of providing the care to the pati
essential modifiers
Capitated Rates
Short bones
Spinal/Vertebral Column
9. Numbers 1-7 - attach directly to the sternum in the front of the body.
The Current Procedural Terminology (CPT)
true ribs
Fee-for-Service
Abuse
10. Indicates add-on codes
Melanin
Health practitioner
Medicare Claim Status
A plus sign (+)
11. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called
Employer Liability
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Keratin
Complicated
12. 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)
The Good Samaritan Act
Exclusions and Limitations
Short bones
13. Absence of hair from areas where it normally grows
Alopecia
Hairline
Consultation
Sesamoid bones
14. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
sebaceous(oil) glands and the suddoriferous (sweat) glands
There are three layers to the skin
Accept assignment
appendicular skeleton .
15. provides a five-digit code which gives the highest specificity of description to a condition. Use of it is mandatory if it is available. A code not reported to the full number of digits required is invalid. e.g. 240.01 Toxic diffuse goiter with thyr
Sub classification
co-payment
Exclusions and Limitations
Carpals
16. Law passed by the federal government to prosecute cases of Medicaid fraud.
Commercial Carriers
upper appendicular skeleton
Civil Monetary Penalties Law (CMPL)
Liability insurance
17. 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'.
Compliance Regulations
Unlisted Procedures Procedures
Dirty claim
Pre-authorization
18. 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
Established Patient
HCPCS Level II codes (National Codes)
Rejected claim
ulna
19. 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
itemized statement
Surgical Package
Impacted
20. 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
Vesicle
Medicare
Exclusions and Limitations
Personal Insurance
21. the bone is crushed and or shattered.
Two triangular symbols (a
Reasons for Documentation
Musculoskeletal System
Comminuted fracture
22. the bone is broken and the ends are driven into each other.
Impacted
Inferior nasal conchae
Spinal/Vertebral Column
Gangrene
23. 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
Coinsurance
Employer Identification Number (EIN)
Pre-paid Health Plan
co-payment
24. Is when two insurance companies work together to coordinate payment of the benefits.
Coordination of Benefits (COB)
CPT SECTIONS.
Medically needy
Keratin
25. Also called 'global surgery' - includes a variety of services rendered by a surgeon which includes the following: Surgical procedure performed Local infiltration - metacarpal/metatarsal/digital block - or topical anesthesia Preoperative E/M services
Surgical Package
Zygoma
Category III Codes CPT
History
26. Cheekbone
History of present illness (HPI)
Zygoma
Patient Confidentiality
Accident
27. Is a statement of the patient's account history - showing dates of service - detailed charges - payments (i.e. deductibles and co-pays) - the date the insurance claim was submitted - applicable adjustments and account balance.
Location Methods
Fissure
itemized statement
False ribs
28. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
Mutually Exclusive Edits
Performing Provider Identification Number (PPIN)
Provider Identification Number (PIN)
Impetigo
29. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called
Electronic Claim
Keratin
Fissure
Suicide Attempt
30. 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
eponychium
Coordination of Benefits (COB)
Vomer
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
-51 - Multiple Procedures
Qualified diagnosis
Short bones
32. Deficient in pigment (melanin)
No ROM
Albino
Musculoskeletal System
MEDICARE Part B
33. 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
Complicated
TRICARE
Established Patient
Tabular List (Volume 1)...
34.
-50 - Bilateral Procedure
Pubic bone
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Rejected claim
35. Further classified as to primary - secondary - or carcinoma in situ.
Nodule
Commercial Carriers
Palatine bones
Malignant
36. This modifier is used to indicate that the procedure was done by an outside laboratory and not by the reporting facility or clinic.
Sphenoid Bones
-90 - Reference (Outside) Laboratory
Limited ROM
Coinsurance
37. 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
Complicated
Occipital Bone
Pelvis
upper appendicular skeleton
38. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.
Benign
Remittance Advice
Limited ROM
Gender rule
39. Are conditions - situations - and services not covered by the insurance carrier.
History
Subcategories
Exclusions and Limitations
Retention of Medical Records
40. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Limited ROM
Unspecified nature
Chief complaint
Flat bones
41. make up part of the roof of the mouth
Palatine bones
phalanges (phalanx.s)
Civil Monetary Penalties Law (CMPL)
Evaluation and Management Review
42. 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.
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Provider Identification Number (PIN)
Two triangular symbols (a
Colles
43. are composed of a group of three-digit categories representing a group of conditions or related conditions; they are divided into categories. e.g. . - Disorders of Thyroid Gland (240 - 246).
Coinsurance
Sections
Spinal/Vertebral Column
Occipital Bone
44. 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.
Sesamoid bones
Comminuted fracture
Ethmoid Bone
Group Provider Number
45. requires investigation and needs further clarification.
-32 - Mandated Services
Review of Systems (ROS)
Rejected claim
Ethmoid Bone
46. 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
Electronic Claim
Dirty claim
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
47. The fractured area of bone collapses on itself.
Gender rule
Albino
Compression fracture
Remittance Advice
48. 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
Albino
Nonparticipating physician
Categorically needy -MEDICAID
State License Number
49. Developed by the CMS to promote national correct coding methodologies and to control improper coding that leads to inappropriate payment of Part B health insurance claims.
Health practitioner
Sphenoid Bones
Short bones
National Correct Coding Initiative (NCCI)
50. 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.
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Provider Identification Number (PIN)
Colles
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule