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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. Represent changes in the text or definition between the triangles.
stand-alone codes
Two triangular symbols (a
Compression fracture
Category I Codes CPT
2. 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
stand-alone codes
lunula
axial skeleton
Patient Confidentiality
3. Are composed of three-digit codes representing a single disease or condition.
False Claims Act (FCA)
Categories
State License Number
A plus sign (+)
4. Is a cost-sharing requirement for the insured to pay at the time of service. This amount is usually a specific dollar amount (e.g.. $15 - $20 - $25)
co-payment
lunula
Benign (hypertension)
Paper Claim
5. paired bones at the corner of each eye that cradle the tear ducts.
Gender rule
Ethmoid Bone
Patient Confidentiality
Lacrimal bones
6. They are for profit organizations that operate in the private sector selling different health insurance benefits plans to groups or individuals. Most commercial plans have predefined patient yearly deductibles and coinsurance generally based on 80/2
Commercial Carriers
Blue Cross/Blue Shield Plans
Accident
Undetermined
7. forms the roof of the nasal cavity.
Outpatient
Rib Cage
Ethmoid Bone
Collagen
8. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.
The St. Anthony Relative Value for Physicians (RVP)
National Correct Coding Initiative (NCCI)
Impetigo
appendicular skeleton .
9. 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
Subcategories
Keratin
Fraud
Radius
10. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.
Palatine bones
New patient
MEDICARE Part C
Participating physician
11. Are conditions - situations - and services not covered by the insurance carrier.
Exclusions and Limitations
Employee Liability
Dirty claim
Coinsurance
12. 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
Coinsurance
Secondary malignancy
Category I Codes CPT
Limited ROM
13. 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.
nonessential modifiers
False Claims Act (FCA)
MEDICARE Part C
appendicular skeleton .
14. Describes the services billed and includes a breakdown of how the payment is determined
Explanation of Benefits (EOB)
Ulcermembranes
bullet (a
Sphenoid Bones
15. 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
Colles
Humerus
Health practitioner
HCPCS Level II codes (National Codes)
16. 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.
Patient Confidentiality
Medicaid
Patient Confidentiality
upper appendicular skeleton
17. poisoning was inflicted by another person with intent to kill or injure
The St. Anthony Relative Value for Physicians (RVP)
Assault
Long bones
Unique Provider Identification Number (UPIN)
18. 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.
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
Participating physician
Modifiers
-51 - Multiple Procedures
19. A minor fracture appears as a thin line on x-ray and may not extend completely through the bone.
Hairline
The Integumentary System
Chief complaint
Category II Codes CPT
20. Groove or crack like sore
-26 - Professional Component
Fissure
Nonparticipating physician
-24 - Unrelated E/M Service by the Same Physician During a Postoperative Period
21. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.
Malignant
appendicular skeleton .
Contracted Rates with MCOs
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
22. 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
sebaceous(oil) glands and the suddoriferous (sweat) glands
Temporal Bone
Health Insurance Portability and Accountability Act (HIPAA)
MEDICARE Part D
23. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.
The Good Samaritan Act
Unlisted Procedures Procedures
premium
nonessential modifiers
24. means the provider agrees to accept what the insurance company approves as payment in full for the claim.
Accept assignment
Unspecified (hypertension)
Coinsurance
Rejected claim
25. 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..
Collagen
Musculoskeletal System
Pubic bone
phalanges (phalanx.s)
26. They are for profit organizations that operate in the private sector selling different health insurance benefits plans to groups or individuals. Most commercial plans have predefined patient yearly deductibles and coinsurance generally based on 80/2
Palatine bones
Chief complaint
Commercial Carriers
lunula
27. Forms the sides of the cranium
Wheal
Parietal Bones
Unique Provider Identification Number (UPIN)
Pre-certification
28. Mild or controlled hypertension and no damage to the vascular system or organs.
Benign
Benign (hypertension)
Multigravida
The Integumentary System
29. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.
Wheal
The St. Anthony Relative Value for Physicians (RVP)
Civil Monetary Penalties Law (CMPL)
Medicare's Resource Based Relative Value Scale (RBRVS) Payment Schedule
30. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the
Coordination of Benefits (COB)
MEDICARE Part A
Short bones
Group Provider Number
31. forms the two lower sides of the cranium.
Ethmoid Bone
Established Patient
nonessential modifiers
Temporal Bone
32. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.
Location Methods
Sections
Occipital Bone
Chief complaint
33. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)
Impacted
Fee Schedule
Medically needy
Floating ribs Ribs 11 and 12 are - because they are not attached at all.
34. Includes - but is not limited to - physician assistant - certified nurse-midwife - qualified psychologist - nurse practitioner - clinical social worker - physical therapist - occupational therapist - respiratory therapist - certified registered nurse
co-payment
State License Number
eponychium
Health practitioner
35. 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
itemized statement
Comminuted fracture
The Integumentary System
Dirty claim
36. Is the lateral lower arm bone (in line with the thumb).
Radius
Carpals
circle with a line through it)
Preferred Provider Organization (PPO)
37. The fractured area of bone collapses on itself.
Vomer
Compression fracture
upplementary Classification of Factors Influencing Health Status and Contact with Health Services (V Codes)
Fissure
38. 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
Frontal Bone
Past - family and social history (PFSH)
Spinal/Vertebral Column
Birthday rule
39. 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
Occipital Bone
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
State License Number
40. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.
Consultation
Group practice
Long bones
triangle (a
41. 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
Inferior nasal conchae
Coordination of Benefits (COB)
Nonparticipating physician
42. The fractured area of bone collapses on itself.
circle with a line through it)
Compression fracture
New Patient
Benign (hypertension)
43. Is a working diagnosis which is not yet established.
Musculoskeletal System
Deductible
Qualified diagnosis
Civil Monetary Penalties Law (CMPL)
44. Are composed of three-digit codes representing a single disease or condition.
Fee Schedule
Categories
Modifiers
-50 - Bilateral Procedure
45. consists of 17 chapters based on either body system or cause or type of disease. The codes range from 001-999.
Complicated
Benign
Tabular List (Volume 1)...
History of present illness (HPI)
46. anterior to the temporal bones.
Sphenoid Bones
79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period
New Patient
Blue Cross/Blue Shield Plans
47. Number assigned to the physician by Medicare program.
Polyp
Limited ROM
Malignant
Unique Provider Identification Number (UPIN)
48. 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
Chief complaint (CC)
Rejected claim
Hairline
Sebaceous glands
49. 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 C
No ROM
-58 - Staged or Related Procedure or Service by the same Physician during the Postoperative Period
Zygoma
50. 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
Consultation
The Universal Claim Form
Abuse
Medical necessity