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Medical Coding Basics

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. How are bones categorized?
Treatment
Turning Outward
The Axial Skeleton and the Appendicular Skeleton
Record

2. Who does TRICARE cover?
Forms the back of the skull
Ankle
When a person who is not sick/injured seeks health services for a specific thing (immunizations - organ donors) -When a person with a chronic condition presents for specific treatment of that condition (diabtetes) -When a circumstance influences the
Active - retired - survivors and their families of the Armed Forces.

3. Who investigates and prosecutes Health Care fraud?
Between
The Axial Skeleton and the Appendicular Skeleton
Office of Inspector General (OIG)
Karatin

4. Melanin
Vulva
Before
CMS-1500
Major skin pigment

5. When can a provider share PHI without specific permission from the patient?

6. Occipital Bone
The bone is broken and pierces an organ.
Half
Forms the back of the skull
Milk

7. What is a Complicated Fracture?
Uteris
Bones at the corner of each eye that cradle the tearducts
The bone is broken and pierces an organ.
Below

8. What does a bullet in the CPT code book next to a code mean?
A new procedure or service since the previous edition.
Provides medical benefits to spouses and children of veterans with total - permanent - service related disabilities- or have died.
1. Epidermis (Top layer) 2. Dermis (Middle layer) 3. Subcutaneous Layer
Middle of the body.

9. inter
Coccyx (Tailbone)
Fibrous bands of ligaments
Between
Surgical Fixation

10. pan
Middle of the foot bone
Ankle
Turning the palm or foot upward
All

11. Radius
Noninvasive - non-spreading - nonmalignant.
Lower arm bone in line with the thumb
1. The provider's usual charge for the service 2. The average charge of all the other providers in the same geographical area 3. The actual charge submitted on the claim The lowest amount is used as basis for the payment.
1. Volume 1; Tabular List 2. Volume 2; Diseases - Alphabetic Index 3. Volume 3; Procedures - tabular list and index

12. epi
Discharge - Flow
Strong - broad and have large surfaces for muscles to attach to.
Above
Small with irregular shapes (ie wrist and ankle)

13. -pexy
Surgical Fixation
1. For treatment (discussing the case with another professional)2.Payment (When providers submit claims on the patient's behalf).3. Operations: Staff training and Quality Improvement.
1. Malignant (Accelerated and severe) 2. Benign (Mild or controlled) 3. Unspecified (Not specified in the Medical Record)
Discolored - flat lesion

14. What is Employer Liability?

15. -therapy
A change in the code description since the last edition.
Vulva
Treatment
Stomach

16. What are bones connected together with?
Skull - Ribcage and Spine.
1. Column 1/ Column 2; identified unbundled codes.2. Mutually Exclusive Edits: Codes that are unlikely to be performed on the same patient in the same day.
Fibrous bands of ligaments
Blood Condition

17. What is a Comminuted Fracture?
Fibrous bands of ligaments
Head
Bones the palm of the hand
The bone is crushed or shattered.

18. Abduction
Bone that forms the wall between the nostrils
Movement away from the midline
Turning Outward
Bones covering body parts (ie shoulder blades - ribs - pelvic bones)

19. dys
Free moving joints that are surrounded by joint capsules.
Painful - difficult
Four
The original cancer site. Malignant tumores are considered primary unless documented as secondary or metastatic.

20. -rrhagia
Physicians are legally responsible for their actions and their employee's actions. a.k.a Respondant Superior. (Let the master answer.)
5. (ex 311.56)
Stomach
Bursting forth blood

21. Vesicle
Small collection of clear fluid; blister
Inflammation
Noninvasive - non-spreading - nonmalignant.
Record

22. -rrhaphy
Suture
Reimbursement is sent directly from payer to the provider.
Small - rounded bones that resemble sesame seeds that are found near joints. (ie knee cap)
Lunula

23. Sesamoid Bones
A new procedure or service since the previous edition.
Upper Jawbone
Small - rounded bones that resemble sesame seeds that are found near joints. (ie knee cap)
Cancer that has spread to a secondary site.

24. nat/
Lung
Without
Birth
1. The provider's usual charge for the service 2. The average charge of all the other providers in the same geographical area 3. The actual charge submitted on the claim The lowest amount is used as basis for the payment.

25. Eversion
Smaller - lateral leg bone
CMS-1500
Lower medial arm bone
Turning Outward

26. What are the two provisions of HIPPA?
1. Insurance Reform 2. Administrative Simplification
Discharge - Flow
Within
Through

27. cardi/
CMS
Cancer that has spread to a secondary site.
Cancer that has localized and not spread at all.
Heart

28. What is Fiscal Intermediary?
The bone is broken and pierces an organ.
Nose
Protection against loss of money caused by failure through error or unintentional omission of the individual or service submitting the claim.
An insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.

29. -oma
Back part of the body.
CMS-1500
Mass
Movement toward the midline

30. What is a Comminuted Fracture?
Osseous
Slow
The bone is crushed or shattered.
In the cause of injury - poisoning - accidents or other adverse effects.

31. sub
Under
Visual Examination
No.
Middle of the body.

32. What does a triangle in the CPT book next to a code mean?
A change in the code description since the last edition.
1996
Surgical Puncture
Milk

33. Humerus
Milk
Office of Inspector General (OIG)
Upper Arm bone
Initiative developed by CMS to promote national correct coding methods and control improper coding that leads to wrong payments of Part B health claims.

34. What is secondary malignancy?
1. Volume 1; Tabular List 2. Volume 2; Diseases - Alphabetic Index 3. Volume 3; Procedures - tabular list and index
Governed by State and Local laws; should be retained indefinitely. For deceased patients - they should be kept at least 5 years.
Forms the two lower sides of the cranium
Cancer that has spread to a secondary site.

35. What is Employee Liability Insurance?
Protection against loss of money caused by failure through error or unintentional omission of the individual or service submitting the claim.
Middle of the body.
Moving forward
In front of the temporal bones

36. What is the False Claims Act (FCA)
A Federal law that prohibits submitting a false claim or making a false statement or representation in connection with a claim.
Vertical plane dividing the body to the left and the right sides.
Cartilage
Provides medical benefits to spouses and children of veterans with total - permanent - service related disabilities- or have died.

37. What does a bullet in the CPT code book next to a code mean?
Without
A new procedure or service since the previous edition.
Absence of hair
Fallopian tubes

38. gastro/
Before - in front of
Stomach
Before
Bones the palm of the hand

39. lact/
Milk
Movement toward the midline
Four
Suture

40. Short Bones
Small with irregular shapes (ie wrist and ankle)
Separation - Breakdown
Blood Condition
Four

41. -algia
Skull - Ribcage and Spine.
Pain
Lower Jawbone
Hind foot bone

42. When billing an insurance company - what information must be included?
Disease Condition
Slow
False
Date of Service (DOS) -Place of Service (POS) -Type of Service (TOS) -Diagnosis -Procedure(s)

43. How many volumes is the ICD-9 manual divided into?
Muscle
1. Volume 1; Tabular List 2. Volume 2; Diseases - Alphabetic Index 3. Volume 3; Procedures - tabular list and index
Between
Bones the palm of the hand

44. Thoracic
Movement toward the midline
Upper Back
Forms the sides of the cranium
Milk

45. What is the name of the claim form that is standard for submitting claims?
CMS-1500
Opening
Small collection of clear fluid; blister
Against

46. Parietal Bones
Forms the sides of the cranium
Toe Bones
Active - retired - survivors and their families of the Armed Forces.
Forms the back of the skull

47. -oma
Mass
Small with irregular shapes (ie wrist and ankle)
Vertical plane dividing the body to the left and the right sides.
Out - out of

48. a - an
1. Column 1/ Column 2; identified unbundled codes.2. Mutually Exclusive Edits: Codes that are unlikely to be performed on the same patient in the same day.
Without
Near the point of attachment to the trunk.
Horizontal plane dividing the upper and lower parts of the body.

49. What are bursae?
Cartilage
Upper roof of the mouth
Sacs of fluid located in-between the bones of the joint and tendons that hold the muscles into place.
Stomach

50. myo/
Coccyx (Tailbone)
Muscle
Half
Standards of conduct based on moral principals.