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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 small with irregular shapes. They are found in the wrist and ankle.
Short bones
Birthday rule
Employee Liability
Fee-for-Service
2. 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.
MEDICARE Part B
Salter-Harris
Contracted Rates with MCOs
Medicare Claim Status
3. The fractured area of bone collapses on itself.
-51 - Multiple Procedures
sebaceous(oil) glands and the suddoriferous (sweat) glands
Compression fracture
Short bones
4. The reason the patient came to see the physician.
Electronic Claim
Albino
Category II Codes CPT
Chief complaint (CC)
5. Produce secretions that allow the body to be moisturized or cooled.
Exclusions and Limitations
Coordination of Benefits (COB)
sebaceous(oil) glands and the suddoriferous (sweat) glands
Sections
6. Upper jaw bone
Retention of Medical Records
Spinal/Vertebral Column
-26 - Professional Component
Maxilla
7. Is a group of two or more physicians and non-physician practitioners legally organized in a partnership - professional corporation - foundation - not-for-profit corporation - faculty practice plan - or similar association.
Civil Monetary Penalties Law (CMPL)
Provider Identification Number (PIN)
The Current Procedural Terminology (CPT)
Group practice
8. 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
Neoplasm Table
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Clean claim
Inpatient
9. Was created to provide medical benefits to spouses and children of veterans with total - permanent service related disabilities or for surviving spouses and children of a veteran who died as a result of service-related disability. It is a service ben
Sub classification
true ribs
Impetigo
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
10. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
-99 - Multiple Modifiers
Fissure
-78 - Return to the Operating Room for a Related Procedure During the Postoperative Period
Carcinoma (Ca) in situ
11. 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
Inpatient
History of present illness (HPI)
CPT SECTIONS.
Salter-Harris
12. 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
Sections
Unlisted Procedures Procedures
Health Care Financing Administration Common Procedure Coding System
Comminuted fracture
13. Groove or crack like sore
Accept assignment
Fissure
Vomer
Surgical Package
14. cancer that is localized and has not spread to adjacent tissues or distant parts of the body
History
stand-alone codes
Carcinoma (Ca) in situ
Mutually Exclusive Edits
15. Prescription Drugs The Medicare Prescription Drug - Improvement - and Modernization Act enacted in December 2003 and began implementation in January 2006 where Medicare beneficiaries can enroll in the Medicare prescription drug plan. The beneficiari
MEDICARE Part A
MEDICARE Part D
Uncertain behavior
Participating physician
16. Was created to provide medical benefits to spouses and children of veterans with total - permanent service related disabilities or for surviving spouses and children of a veteran who died as a result of service-related disability. It is a service ben
CHAMPVA (Civilian Health and Medical Program of the Veterans Affairs)
Capitated Rates
There are three layers to the skin
Medicare
17. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.
-90 - Reference (Outside) Laboratory
Keratin
Deductible
Personal Insurance
18. 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
The Patient Care Partnership (Patient's Bill of Rights)
Liability insurance
stand-alone codes
Fee Schedule
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:
Flat bones
ulna
axial skeleton
Hypertension Table
20. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients
Established patient
HCPCS Level I codes
Unauthorized benefit
Melanin
21. 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
Pubic bone
Comminuted fracture
Supplementary Classification of External Causes of Injury and Poisoning (E Codes)
HCPCS Level II codes (National Codes)
22. 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
There are three layers to the skin
Group practice
Vomer
Collagen
23. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.
Unspecified nature
Physician
There are three layers to the skin
Inpatient
24. 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
Mandible
Medicare
Ethmoid Bone
sebaceous(oil) glands and the suddoriferous (sweat) glands
25. is basically the same as HMO in the sense that the health care provider enters into contract with the MCOs to render services to the beneficiaries. However - PPO's charge a higher premium than HMO's in exchange for more flexibility and more options
Gangrene
Clearinghouse
Advance Beneficiary Notice
Preferred Provider Organization (PPO)
26. The spinal /vertebral column is divided into five regions from the neck to the tailbone. There are 26 bones in the spine and they are referred to as the vertebrae. The following list explains the bones of the spine: Cervical -Neck Bones -Thoracic -U
Review of Systems (ROS)
Undetermined
Neoplasm Table
Spinal/Vertebral Column
27. Provide the means by which the reporting physician can indicate that a service or procedure that has been performed has been altered by some specific circumstance but not changed in its definition or code.
Uncertain behavior
Rejected claim
Workers Compensation
Modifiers
28. 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
Lacrimal bones
Point-of-Service plan (POS)
Gangrene
Accident
29. 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
MEDICARE Part B
Health Insurance Portability and Accountability Act (HIPAA)
MEDICARE Part C
Vesicle
30. 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).
Paper Claim
Frontal Bone
Dirty claim
Chapters
31. open sore on the skin or mucous
Dirty claim
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
eponychium
Ulcermembranes
32. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients
Medically needy
Zygoma
HCPCS Level I codes
Categorically needy -MEDICAID
33. 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
upper appendicular skeleton
Exclusions and Limitations
Mandible
Clearinghouse
34. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.
Medicaid
Employer Liability
Coding
Nodule
35. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Accept assignment
Uncertain behavior
Impacted
sebaceous(oil) glands and the suddoriferous (sweat) glands
36. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.
Limited ROM
Column 1/Column 2 (previously called Comprehensive/Component) Edits
Retention of Medical Records
Macule
37. 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
Malignant
Unlisted Procedures Procedures
Blue Cross/Blue Shield Plans
38. Forms the sides of the cranium
MEDICARE Part D
Neoplasm Table
Parietal Bones
Employer Liability
39. 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'.
Add-on codes
-51 - Multiple Procedures
Pre-authorization
Categories
40. Is an electronic or paper-based report of payment sent by the payer to the provider.
Unique Provider Identification Number (UPIN)
Reasons for Documentation
Remittance Advice
HCPCS Level II codes (National Codes)
41. Are conditions - situations - and services not covered by the insurance carrier.
Compression fracture
Ischium
Exclusions and Limitations
premium
42. is referred to as Supplementary Medical Insurance (SMI). This coverage is a supplement to Part A - which covers medical expenses - clinical laboratory services - home health care - outpatient hospital treatment - blood - and ambulatory surgical serv
Contracted Rates with MCOs
Long bones
MEDICARE Part B
Clean claim
43. Forms the anterior part of the skull and the forehead
Melanin
Unique Provider Identification Number (UPIN)
Frontal Bone
Pre-authorization
44. forms the roof of the nasal cavity.
Medicaid
Assault
Category I Codes CPT
Ethmoid Bone
45. This modifier is used to explain that the procedure or service done during a postoperative period was planned at the time of the original procedure. This is also used if a therapeutic procedure is performed because of the findings from a diagnostic p
Advance Beneficiary Notice
Accept assignment
-99 - Multiple Modifiers
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
46. major skin pigment
Health Insurance Portability and Accountability Act (HIPAA)
Chief complaint
Melanin
The Integumentary System
47. This is the traditional method used by providers for submission of charges to insurance companies. The most commonly used form is the CMS-1500. Few plans still accept the physician's encounter form or superbill and Medicare will only accept claims on
Paper Claim
Neoplasm Table
Category III Codes CPT
Sebaceous glands
48. The moon like white area at the base of the nail.
Employee Liability
lunula
New Patient
Chief complaint (CC)
49. numbers 8-10 - are attached to the sternum by cartilage
False ribs
Multigravida
Commercial Carriers
Flat bones
50. Under this schedule - a procedure's relative value is the sum total of three elements: Work: represents the amount of time - intensity of effort - and medical skill required of the physician. Overhead: practice costs related to the performing of the
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