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. Any fracture occurring spontaneously as a result of disease.
Social Security Number
Pathologic
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
No ROM
2. Typically not used on the claim form unless the provider does not have an EIN.
Group Insurance
Hypertension Table
Radius
Social Security Number
3.
Medicare Claim Status
Health Care Financing Administration Common Procedure Coding System
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Fraud
4. Absence of hair from areas where it normally grows
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
Alopecia
Pre-certification
Sub classification
5. This is a set of information the physician gathers from the patient regarding the following:
Invalid claim
History
Ulcermembranes
Carcinoma (Ca) in situ
6. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).
Reasons for Documentation
Categorically needy -MEDICAID
No ROM
Column 1/Column 2 (previously called Comprehensive/Component) Edits
7. Knowingly and intentionally deceiving or misrepresenting information that may result in unauthorized benefits is known as fraud.. Common forms of fraud are billing for services not furnished - unbundling - and misrepresenting diagnosis to justify pay
Deductible
Modifiers
Pathologic
Fraud
8. 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
There are three layers to the skin
TRICARE PLANS
Workers Compensation
Malignant
9. The E&M section includes codes that pertain to the nature of the physicians' work. The codes depend on type of service - patient status - and place where service was rendered. The E&M section is divided into broad categories such as office visits - h
Evaluation and Management Review
Unlisted Procedures Procedures
encounter form
Benign
10. most synarthroses are immovable joints held together by fibrous tissue.
eponychium
-90 - Reference (Outside) Laboratory
Consultation
No ROM
11. 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
Two triangular symbols (a
MEDICARE Part C
Gender rule
appendicular skeleton .
12. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
Qualified diagnosis
Deductible
Unauthorized benefit
There are two types of sweat glands
13. Poisoning cannot be determined whether intentional or accidental.
Undetermined
Liability insurance
Evaluation and Management Review
Chapters
14. 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)
Chapters
Category III Codes CPT
-50 - Bilateral Procedure
15. 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.
Coordination of Benefits (COB)
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
ulna
16. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
Mandible
appendicular skeleton .
Fiscal Intermediary
MEDICARE Part D
17. Are wrist bones. There are 2 rows of four bones in the wrist. The metacarpals are the five radiating bones in the fingers. These are the bones in the palm of the hand.
Temporal Bone
Carpals
Hairline
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
18. 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
Surgical Package
Group Provider Number
Medical Records
19. 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:
-90 - Reference (Outside) Laboratory
Outpatient
bullet (a
Hypertension Table
20. An insurance plan issued to an individual. Premium rates are usually higher than group rates and service availability is lessened with this type of coverage.
ulna
TRICARE PLANS
Eligibility
Personal Insurance
21. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.
Alopecia
Evaluation and Management Review
Assault
Peer Review Organization (PRO)
22. This is also known as fee-for-service. Under this plan - the services that are paid for are listed in the policy and payments are based on the fees physicians charge for the service. Each year - the beneficiary must meet a deductible - after which -
Indemnity Insurance
Pubic bone
essential modifiers
TRICARE
23. Is to determine the patient's benefits and the maximum dollar amount that the insurance company will pay. Often the first step of the insurance verification process - it is completed prior to the first visit.
Coordination of Benefits (COB)
Location Methods
Pre-determination
Category III Codes CPT
24. 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
Lacrimal bones
Capitated Rates
Uncertain behavior
Provider Identification Number (PIN)
25. forms the two lower sides of the cranium.
Parietal Bones
MEDICARE Part C
A plus sign (+)
Temporal Bone
26. 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
nonessential modifiers
Physician
Location Methods
Long bones
27. The lower anterior part of the bone
Pubic bone
TRICARE PLANS
encounter form
Employee Liability
28. This is not specified as benign or malignant in the diagnosis or medical record.
Malignant
Melanin
Unspecified (hypertension)
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
29. forms the roof of the nasal cavity.
ligaments
Explanation of Benefits (EOB)
The Integumentary System
Ethmoid Bone
30. This is also known as fee-for-service. Under this plan - the services that are paid for are listed in the policy and payments are based on the fees physicians charge for the service. Each year - the beneficiary must meet a deductible - after which -
Humerus
Fee Schedule
Indemnity Insurance
Exclusions and Limitations
31. forms the roof of the nasal cavity.
Palatine bones
Exclusions and Limitations
Ethmoid Bone
HCPCS Level I codes
32. Contains complete - necessary information - but is incorrect or illogical in some way.
Occipital Bone
Alphabetic Index (Volume 2)
Multigravida
Invalid claim
33. 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.
Gangrene
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Commercial Carriers
Tabular List (Volume 1)...
34. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).
Lipocyte
appendicular skeleton .
Column 1/Column 2 (previously called Comprehensive/Component) Edits
essential modifiers
35. 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.
Sphenoid Bones
Keratin
Advance Beneficiary Notice
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
36. Are conditions - situations - and services not covered by the insurance carrier.
Exclusions and Limitations
The Universal Claim Form
Full ROM
Eligibility
37. 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.
Retention of Medical Records
Performing Provider Identification Number (PPIN)
There are two types of sweat glands
Benign
38. Is a working diagnosis which is not yet established.
Zygoma
Unauthorized benefit
Qualified diagnosis
Fraud
39. The fractured area of bone collapses on itself.
The St. Anthony Relative Value for Physicians (RVP)
Fissure
Compression fracture
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
40. Provide a four-digit code (one digit after the decimal point) which is more specific than category code (3-digit) in terms of cause - site - or manifestation of the condition. This must be used if available. From subcategory - specificity moves to an
No ROM
Subcategories
Established patient
-50 - Bilateral Procedure
41. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.
Peer Review Organization (PRO)
Unspecified nature
Established Patient
Lipocyte
42. 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
Peer Review Organization (PRO)
Non-covered benefit
Malignant
ligaments
43. This modifier is used when the same procedure is performed on a mirror-image part of the body..
-50 - Bilateral Procedure
Peer Review Organization (PRO)
TRICARE
New patient
44. Physicians agree to provide services at a discount of their usual fee in return for a pool of existing patients.
Sebaceous glands
Contracted Rates with MCOs
Employee Liability
Unauthorized benefit
45. solid - round or oval elevated lesion more than 1 cm in diameter
Medicare
HCPCS Level II codes (National Codes)
Nodule
Performing Provider Identification Number (PPIN)
46. 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
Exclusions and Limitations
Location Methods
Subcategories
Inferior nasal conchae
47. The physician must obtain this number in order to practice within a state.
Assault
Invalid claim
State License Number
Relative Value Payment Schedules Method
48. 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
Inpatient
Complicated
Group Insurance
HCPCS Level II codes (National Codes)
49. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Musculoskeletal System
Tabular List (Volume 1)...
Categorically needy -MEDICAID
Coding
50. Considered experimental - newly approved - or seldom used may not be listed in the CPT manual. These codes can be coded as unlisted procedures. They are located at the end of the subsections or subheadings. When an unlisted procedure code is reported
Lipocyte
No ROM
Unlisted Procedures Procedures
nonessential modifiers
Sorry!:) No result found.
Can you answer 50 questions in 15 minutes?
Let me suggest you:
Browse all subjects
Browse all tests
Most popular tests
Major Subjects
Tests & Exams
AP
CLEP
DSST
GRE
SAT
GMAT
Certifications
CISSP go to https://www.isc2.org/
PMP
ITIL
RHCE
MCTS
More...
IT Skills
Android Programming
Data Modeling
Objective C Programming
Basic Python Programming
Adobe Illustrator
More...
Business Skills
Advertising Techniques
Business Accounting Basics
Business Strategy
Human Resource Management
Marketing Basics
More...
Soft Skills
Body Language
People Skills
Public Speaking
Persuasion
Job Hunting And Resumes
More...
Vocabulary
GRE Vocab
SAT Vocab
TOEFL Essential Vocab
Basic English Words For All
Global Words You Should Know
Business English
More...
Languages
AP German Vocab
AP Latin Vocab
SAT Subject Test: French
Italian Survival
Norwegian Survival
More...
Engineering
Audio Engineering
Computer Science Engineering
Aerospace Engineering
Chemical Engineering
Structural Engineering
More...
Health Sciences
Basic Nursing Skills
Health Science Language Fundamentals
Veterinary Technology Medical Language
Cardiology
Clinical Surgery
More...
English
Grammar Fundamentals
Literary And Rhetorical Vocab
Elements Of Style Vocab
Introduction To English Major
Complete Advanced Sentences
Literature
Homonyms
More...
Math
Algebra Formulas
Basic Arithmetic: Measurements
Metric Conversions
Geometric Properties
Important Math Facts
Number Sense Vocab
Business Math
More...
Other Major Subjects
Science
Economics
History
Law
Performing-arts
Cooking
Logic & Reasoning
Trivia
Browse all subjects
Browse all tests
Most popular tests