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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 brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Chief complaint
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Flat bones
Parietal Bones
2. 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
Rib Cage
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Advance Beneficiary Notice
3. 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.
Carcinoma (Ca) in situ
Retention of Medical Records
premium
Multigravida
4. Used for procedures that is always performed during the same operative session as another surgery in addition to the primary service/procedure and is never performed separately.
Birthday rule
Add-on codes
Category I Codes CPT
Carpals
5. Deficient in pigment (melanin)
Salter-Harris
Fiscal Intermediary
Albino
Compression fracture
6. These parenthetic terms are called because their presence or absence does not have an effect on the selection of the code listed for the main term.
Paper Claim
Disability insurance
Sebaceous glands
nonessential modifiers
7. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
encounter form
upper appendicular skeleton
Pre-authorization
Carcinoma (Ca) in situ
8. paired bones at the corner of each eye that cradle the tear ducts.
Medical necessity
Lacrimal bones
Hairline
Primary malignancy
9. 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)
Clean claim
Unlisted Procedures Procedures
10. Is when two insurance companies work together to coordinate payment of the benefits.
Coordination of Benefits (COB)
Group practice
Outpatient
Workers Compensation
11. major skin pigment
New patient
Melanin
Unspecified (hypertension)
Parietal Bones
12. 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
Fee Schedule
Outpatient
Carcinoma (Ca) in situ
13. Cheekbone
Zygoma
Malignant
Unlisted Procedures Procedures
Ischium
14. 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.
Flat bones
Participating physician
Medicare Claim Status
Employer Liability
15. This is a set of information the physician gathers from the patient regarding the following:
History
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
TRICARE
A plus sign (+)
16. 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).
premium
Malignant
Sections
Medigap (Medicare Supplemental Insurance)
17. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.
triangle (a
Alopecia
Employer Identification Number (EIN)
Rib Cage
18. Is a working diagnosis which is not yet established.
Humerus
Qualified diagnosis
Coordination of Benefits (COB)
Chief complaint
19. is defined as one who has not received any medical services within the last three years.
Health Insurance Portability and Accountability Act (HIPAA)
MEDICAID COVERAGE
Coinsurance
New Patient
20. The skin and its accessory organs.Integument means covering. The skin covers over an area of 22 square feet ( an average adult). It is a complex system of specialized tissues containing glands - nerves and blood vessels. The main function of the skin
Benign (hypertension)
Vomer
The Integumentary System
Musculoskeletal System
21. 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
sebaceous(oil) glands and the suddoriferous (sweat) glands
Remittance Advice
Coinsurance
Contracted Rates with MCOs
22. Also known as Federal tax identification number. This is issued by the Internal Revenue Service
axial skeleton
Employer Identification Number (EIN)
Frontal Bone
stand-alone codes
23. .. lower jaw bone.
Mandible
Pre-paid Health Plan
Accept assignment
Macule
24. 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.
False Claims Act (FCA)
Birthday rule
Medicaid
Outpatient
25. Typically not used on the claim form unless the provider does not have an EIN.
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Social Security Number
Group practice
26. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
Blue Cross/Blue Shield Plans
Workers Compensation
The Good Samaritan Act
CPT SECTIONS.
27. 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
Medical necessity
Alopecia
Coinsurance
Group practice
28. The physician must obtain this number in order to practice within a state.
Indemnity Insurance
State License Number
Medicare
Compression fracture
29. Are conditions - situations - and services not covered by the insurance carrier.
Exclusions and Limitations
Benign (hypertension)
Uncertain behavior
False ribs
30. 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.
Alphabetic Index (Volume 2)
Accept assignment
Occipital Bone
itemized statement
31. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called
Limited ROM
Keratin
Unspecified (hypertension)
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
32. paired bones at the corner of each eye that cradle the tear ducts.
stand-alone codes
Lacrimal bones
Colles
Pre-determination
33. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.
Qualified diagnosis
Mutually Exclusive Edits
ligaments
Impetigo
34. requires investigation and needs further clarification.
Group Provider Number
The Universal Claim Form
Rejected claim
The Universal Claim Form
35. requires investigation and needs further clarification.
Sebaceous glands
Coordination of Benefits (COB)
Rejected claim
Coinsurance
36. 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
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
The Universal Claim Form
stand-alone codes
Accident
37. 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.
HCPCS Level I codes
axial skeleton
Established Patient
sebaceous(oil) glands and the suddoriferous (sweat) glands
38. Poisoning cannot be determined whether intentional or accidental.
Employer Liability
Group Provider Number
Add-on codes
Undetermined
39. forms the two lower sides of the cranium.
Temporal Bone
sebaceous(oil) glands and the suddoriferous (sweat) glands
Two triangular symbols (a
Location Methods
40. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.
Comminuted fracture
Health Insurance Portability and Accountability Act (HIPAA)
Maxilla
Medical necessity
41. Mild or controlled hypertension and no damage to the vascular system or organs.
Benign (hypertension)
Peer Review Organization (PRO)
Ulcermembranes
Chief complaint (CC)
42. make up part of the roof of the mouth
Fissure
Palatine bones
Participating physician
Tabular List (Volume 1)...
43. 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).
Non-covered benefit
Ethmoid Bone
Chapters
Ischium
44. Contain the full description of the procedure for the code indented codes: these are codes listed under associated stand-alone codes. To complete the description for indented codes - one must refer to the portion of the stand alone code description b
-50 - Bilateral Procedure
stand-alone codes
Two triangular symbols (a
Birthday rule
45. Is a policy that covers losses to a third party caused by the insured - by an object owned by the insured - or on premises owned by the insured. Liability insurance claims are made to cover the cost of medical care for traumatic injuries - lost wages
False Claims Act (FCA)
Liability insurance
Provider Identification Number (PIN)
Melanin
46. When a group of employees and their dependents are insured under one (1) group policy issued to the employer. Generally - the employer pays the premium or a portion of the premium and the employee pays the difference. This all depends on the type of
Commercial Carriers
Group Insurance
MEDICARE Part A
Chief complaint (CC)
47. The cuticle at the lower part of the nail and this is sometimes referred to as the
Health Maintenance Organization (HMO)
eponychium
Medical Records
Wheal
48. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
Flat bones
Limited ROM
Hypertension Table
Parietal Bones
49. represents Exemption from the use of modifier -51
Contracted Rates with MCOs
Established patient
Impacted
circle with a line through it)
50. Consists of the skull - rib cage - and spine
axial skeleton
MEDICARE Part A
Categories
New Patient