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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.
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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. 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.
Relative Value Payment Schedules Method
The St. Anthony Relative Value for Physicians (RVP)
Performing Provider Identification Number (PPIN)
Musculoskeletal System
2. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
There are three layers to the skin
Wheal
Lacrimal bones
Colles
3. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
Medically needy
Modifiers
Liability insurance
triangle (a
4. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)
Pre-determination
The St. Anthony Relative Value for Physicians (RVP)
Full ROM
TRICARE
5. This is located in the Index under the main term 'Neoplasm' and is organized by anatomic site. Each site has six columns with six possible codes determined by whether the neoplasm is malignant - benign - of uncertain behavior - or of unspecified natu
-32 - Mandated Services
true ribs
Impetigo
Neoplasm Table
6. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients
co-payment
Preferred Provider Organization (PPO)
Birthday rule
HCPCS Level I codes
7. The poisoning was self-inflicted.
Suicide Attempt
Long bones
Nodule
Mutually Exclusive Edits
8. paired bones at the corner of each eye that cradle the tear ducts.
Reasons for Documentation
Lacrimal bones
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Pathologic
9. Is defined as a doctor of medicine or osteopathy - dental medicine - dental surgery - podiatric medicine - optometry - or chiropractic medicine legally authorized to practice by the state in which he/she performs.
Subcategories
Physician
Short bones
Pre-authorization
10. Are small - rounded bones that resemble a sesame seed. They are found near joints and increase the efficiency of muscles near a joint. An example of sesamoid bone is the knee cap.
Review of Systems (ROS)
Compliance Regulations
Sesamoid bones
Indemnity Insurance
11. Deficient in pigment (melanin)
Group practice
Coding
Albino
Coding
12. 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
Health Care Financing Administration Common Procedure Coding System
Ulcermembranes
Remittance Advice
MEDICARE Part C
13. Consists of the skull - rib cage - and spine
axial skeleton
Section 3 Index to External Causes of Injury (E codes)
Coding
Neoplasm Table
14. This modifier is used when the same procedure is performed on a mirror-image part of the body..
Past - family and social history (PFSH)
Unique Provider Identification Number (UPIN)
Unlisted Procedures Procedures
-50 - Bilateral Procedure
15. Poisoning was due to: Accidental overdose; Wrong substance taken; Accidents in use of drugs and biologicals; External causes of poisonings classifiable to 980-989 Therapeutic Use: instances when a correct substance properly taken is the cause of adve
Capitated Rates
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Pre-paid Health Plan
Accident
16. This modifier is used to report a procedure or service that has more than one Modifier but the third-party payer does not allow the addition of multiple modifiers to the code. Modifier -99 is attached to the procedure code and the multiple Modifiers
Hypertension Table
TRICARE PLANS
-99 - Multiple Modifiers
Clean claim
17. A chronological account of the development of the complaint from the first sign or symptom that the patient experienced to the present
New Patient
Medical necessity
History of present illness (HPI)
Ulcermembranes
18. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.
Pre-certification
encounter form
MEDICARE Part B
Flat bones
19. Produce secretions that allow the body to be moisturized or cooled.
Temporal Bone
HCPCS Level II codes (National Codes)
sebaceous(oil) glands and the suddoriferous (sweat) glands
Vomer
20. 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).
ulna
Unspecified (hypertension)
False Claims Act (FCA)
Sections
21. Bone that forms posterior/inferior part of the nasal septal wall between the nostrils.
MEDICARE Part B
Greenstick
Vomer
-26 - Professional Component
22. 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
Category III Codes CPT
Categorically needy -MEDICAID
Malignant
Unauthorized benefit
23. forms the roof of the nasal cavity.
Ethmoid Bone
sprain
Performing Provider Identification Number (PPIN)
Liability insurance
24. 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
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
MEDICARE Part A
ligaments
Chapters
25. 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.
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Employer Liability
Blue Cross/Blue Shield Plans
Past - family and social history (PFSH)
26. Are supplementary classification codes used to describe the reason or external cause of injury - poisoning and other adverse effects. These codes can be found in both Volumes I and II. E codes are used to classify environmental events - circumstances
Palatine bones
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Section 3 Index to External Causes of Injury (E codes)
State License Number
27. 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
Sections
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
Category II Codes CPT
Clearinghouse
28. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Malignant
Paper Claim
Chief complaint
Occipital Bone
29. consists of 17 chapters based on either body system or cause or type of disease. The codes range from 001-999.
Tabular List (Volume 1)...
MEDICARE Part A
Civil Monetary Penalties Law (CMPL)
Sphenoid Bones
30. - is a procedure or service provided without proper authorization or was not covered by a current authorization. The claim is denied and the provider cannot bill the patient for the charges.
Unauthorized benefit
Birthday rule
sprain
Humerus
31. This modifier is used when: more than one procedure is performed during the same surgical episode; one code does not describe all of the procedures performed; and the secondary procedure is not minor or incidental to the major procedure. The followin
Medical necessity
-51 - Multiple Procedures
Comminuted fracture
Nodule
32. Poisoning was due to: Accidental overdose; Wrong substance taken; Accidents in use of drugs and biologicals; External causes of poisonings classifiable to 980-989 Therapeutic Use: instances when a correct substance properly taken is the cause of adve
Accident
New patient
Long bones
Radius
33. The epidermis - the dermis - and the subcutaneous layer. The epidermis is a thin - cellular membrane layer that contains keratin. The dermis is a dense - fibrous - connective tissue that contains collagen. The subcutaneous layer is a thicker and fatt
Lacrimal bones
Sections
Secondary malignancy
There are three layers to the skin
34. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
HCPCS Level I codes
Remittance Advice
Carpals
Flat bones
35. the bone is broken and the ends are driven into each other.
Medically needy
History
Hypertension Table
Impacted
36. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.
Flat bones
TRICARE PLANS
Accident
Provider Identification Number (PIN)
37. Further classified as to primary - secondary - or carcinoma in situ.
History
Malignant
Subcategories
axial skeleton
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.
39. 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.
Two triangular symbols (a
Unlisted Procedures Procedures
Pre-determination
Sebaceous glands
40. 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.
Peer Review Organization (PRO)
Dirty claim
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
TRICARE
41. The bone is broken and pierces an internal organ
Review of Systems (ROS)
Complicated
Coordination of Benefits (COB)
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
42. The fractured area of bone collapses on itself.
Compression fracture
Hypertension Table
stand-alone codes
axial skeleton
43. 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.
Mandible
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
Alopecia
itemized statement
44. Consists of the skull - rib cage - and spine
axial skeleton
Benign
appendicular skeleton .
Sesamoid bones
45. 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 -
Medicare Claim Status
Coding
Albino
Indemnity Insurance
46. Make up part of the interior of the nose.
Inferior nasal conchae
State License Number
Medigap (Medicare Supplemental Insurance)
Health Insurance Portability and Accountability Act (HIPAA)
47. 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.
Fee-for-Service
Categorically needy -MEDICAID
Humerus
Established Patient
48. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
Impetigo
Temporal Bone
TRICARE PLANS
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
49. 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
History of present illness (HPI)
Personal Insurance
Rejected claim
50. open sore on the skin or mucous
Rib Cage
Sebaceous glands
Ulcermembranes
Medical Records