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. 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
Peer Review Organization (PRO)
encounter form
MEDICAID COVERAGE
Categorically needy -MEDICAID
2. Is a managed care plan that gives beneficiaries the option whom to see for services. If the beneficiary goes to see a physician within the network - s/he will receive benefits similar to an HMO. But if the beneficiary chooses to see a physician from
Point-of-Service plan (POS)
Musculoskeletal System
Deductible
New patient
3. Deficient in pigment (melanin)
Albino
-32 - Mandated Services
Unspecified (hypertension)
Indemnity Insurance
4. Medicaid is the payer of last resort. If the patient has Medicare and Medicaid - Medicaid usually pays for the Medicare Part B deductible - coinsurance - and monthly premium amounts. Some of the services covered by Medicaid include the following: Inp
Assault
Carpals
MEDICAID COVERAGE
-99 - Multiple Modifiers
5. 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
TRICARE
Wheal
Clearinghouse
Mandible
6. This is not specified as benign or malignant in the diagnosis or medical record.
essential modifiers
Mutually Exclusive Edits
Compression fracture
Unspecified (hypertension)
7. Has all required fields accurately filled out - contains no deficiencies and passes all edits. The carrier does not require investigation outside of the carrier's operation before paying the claim.
Sub classification
Preferred Provider plan
Clean claim
Deductible
8. death of tissue associated with loss of blood supply
Gangrene
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
Greenstick
ulna
9. A fracture of the epiphyseal plate in children.
Neoplasm Table
Fraud
Suicide Attempt
Salter-Harris
10. 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
Consultation
Malignant
HCPCS Level II codes (National Codes)
11. 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.
Benign (hypertension)
Sphenoid Bones
Ulcermembranes
National Correct Coding Initiative (NCCI)
12. male of household is primary payer
Gender rule
Colles
Accident
circle with a line through it)
13. 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).
Medicare Claim Status
Review of Systems (ROS)
MEDICARE Part C
Chapters
14. Pre-determined set of benefits covered under one set annual fee.
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Indemnity Insurance
Salter-Harris
Pre-paid Health Plan
15. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.
Melanin
History
Musculoskeletal System
Participating physician
16. The poisoning was self-inflicted.
Non-covered benefit
Suicide Attempt
Fraud
Multigravida
17. 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
MEDICARE Part C
Health Insurance Portability and Accountability Act (HIPAA)
Coinsurance
Assault
18. Groove or crack like sore
Fissure
Musculoskeletal System
Compliance Regulations
TRICARE PLANS
19. The musculoskeletal system includes the bones - muscles - and joints The musculoskeletal system acts as a framework for the organs - protects many of those organs - and also provides the organism the ability to move..
Musculoskeletal System
Pre-certification
Alopecia
Benign
20. Medicare Managed Care Plans (Formerly Medicare Plus (+) Choice Plan) was created to offer a number of healthcare services in addition to those available under Part A and Part B. The CMS contracts with managed care plans or provider service organizati
true ribs
MEDICARE Part C
lunula
Chief complaint
21. All patients have a right to privacy and all information should remain privileged. Discuss patient information only with the patient's physician or office personnel that need certain information to do their job. Obtain a signed consent form to releas
Indemnity Insurance
Performing Provider Identification Number (PPIN)
Patient Confidentiality
ulna
22. 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.'
The Universal Claim Form
Medical necessity
Undetermined
History
23. Forms the anterior part of the skull and the forehead
Secondary malignancy
Frontal Bone
The Good Samaritan Act
Location Methods
24. 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
-99 - Multiple Modifiers
Participating physician
CPT SECTIONS.
There are two types of sweat glands
25. 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
co-payment
Location Methods
Primary malignancy
Unique Provider Identification Number (UPIN)
26. open sore on the skin or mucous
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Health Insurance Portability and Accountability Act (HIPAA)
Ulcermembranes
Accept assignment
27.
Sphenoid Bones
Subcategories
Fiscal Intermediary
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
28. forms the two lower sides of the cranium.
Group practice
HCPCS Level II codes (National Codes)
Temporal Bone
Commercial Carriers
29. 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.
Vesicle
Performing Provider Identification Number (PPIN)
Occipital Bone
Albino
30. is defined as one who has not received any medical services within the last three years.
New Patient
Performing Provider Identification Number (PPIN)
Qualified diagnosis
Zygoma
31. The moon like white area at the base of the nail.
Rejected claim
Chief complaint (CC)
lunula
Clean claim
32. 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.
Non-covered benefit
Pre-certification
Palatine bones
Workers Compensation
33. Is made up of the shoulder - collar - pelvic and arms and legs
appendicular skeleton .
Point-of-Service plan (POS)
Peer Review Organization (PRO)
Past - family and social history (PFSH)
34. Most billing-related cases are based on HIPAA and False Claims Act.
Chapters
nonessential modifiers
Compliance Regulations
Occipital Bone
35. Structural protein found in the skin and connective tissue
Primary malignancy
Established Patient
Collagen
Advance Beneficiary Notice
36. 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
The Patient Care Partnership (Patient's Bill of Rights)
Preferred Provider plan
Fee Schedule
Zygoma
37. contains errors or omissions. Usually - these claims do not pass front-end edits. They are either processed manually for resolving problems - or rejected for payment.
Dirty claim
Fee Schedule
Categorically needy -MEDICAID
Fee Schedule
38. 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.
Warning
: Invalid argument supplied for foreach() in
/var/www/html/basicversity.com/show_quiz.php
on line
183
39. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
Established patient
Suicide Attempt
Fiscal Intermediary
Preferred Provider Organization (PPO)
40. 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
Chapters
Sebaceous glands
Group Insurance
National Correct Coding Initiative (NCCI)
41. 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
Medicare
Frontal Bone
ligaments
Temporal Bone
42. 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
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
TRICARE
Fiscal Intermediary
43. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
Employer Identification Number (EIN)
Primary malignancy
Polyp
Unlisted Procedures Procedures
44. Are composed of three-digit codes representing a single disease or condition.
Categories
Disability insurance
-32 - Mandated Services
Collagen
45. Is a patient who receives treatment in any of the following settings: physician's office ;hospital clinic - emergency department - hospital same-day surgery unit - ambulatory surgical center ( patient is released within 23 hours) ;hospital admission
Long bones
Outpatient
Fissure
Accident
46. 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
Participating physician
Disability insurance
Fee Schedule
eponychium
47. Deficient in pigment (melanin)
Limited ROM
Albino
Social Security Number
Preferred Provider plan
48. Make up part of the interior of the nose.
Uncertain behavior
-50 - Bilateral Procedure
Inferior nasal conchae
Commercial Carriers
49. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
Carcinoma (Ca) in situ
Civil Monetary Penalties Law (CMPL)
-90 - Reference (Outside) Laboratory
Modifiers
50. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body
Secondary malignancy
Outpatient
Established Patient
Alopecia