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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.
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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. What is the moon like white area at the base of the nail called?
Lunula
In the cause of injury - poisoning - accidents or other adverse effects.
Fallopian tubes
Bursting forth blood

2. What is the Civil Monetary Penalties Law (CMPL)?
Sacs of fluid located in-between the bones of the joint and tendons that hold the muscles into place.
Wrist bones
Beside
A law passed by the Federal Government to prosecute cases of Medicaid fraud.

3. chondro/
1. Sebaceous (oil) glands 2. Suddiferous (sweat) glands
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.
1996
Cartilage

4. Lipocyte
Lunula
Fat cell
Surgical Procedure Performed -Local infiltration/metatarsal/digit block/anesthesia -Pre-Op E/M services on day before surgery -Immediate Post-Op care -Normal - uncomplicated Post-Op care
Neck Bones

5. arth/
In front of the temporal bones
Cartilage
Stone
Four

6. What does a triangle in the CPT book next to a code mean?
Osseous
Uteris
Breast
A change in the code description since the last edition.

7. What are bones made of?
Hematopoietic tissue
Small - rounded bones that resemble sesame seeds that are found near joints. (ie knee cap)
Osseous
Initiative developed by CMS to promote national correct coding methods and control improper coding that leads to wrong payments of Part B health claims.

8. -meter
An insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
Measure
Discharge - Flow
Under

9. Who investigates and prosecutes Health Care fraud?
Office of Inspector General (OIG)
Epinephrine and Steriods
Many
Painful - difficult

10. What is Assignment of Benefits?
Reimbursement is sent directly from payer to the provider.
A change in the code description since the last edition.
Through
Before - in front of

11. a - an
Without
1996
A break at the distal end of the bone - usually when someone tries to break their fall.
Forms the roof of the nasal cavity

12. anti
Finger Bones
Against
4. (ex 311.0)
Through

13. Impetigo
A pregnant woman who has had at least one pregnancy.
Bacterial inflammatory skin disease with lesions - pustules and vesicles
Breast
Physicians are legally responsible for their actions and their employee's actions. a.k.a Respondant Superior. (Let the master answer.)

14. a - an
Absence of hair
Middle of the foot bone
Removal - Excision - Resection
Without

15. What is a Qualified Diagnosis
A working diagnosis that has not yet been established.
1996
Fibrous bands of ligaments
5. (ex 311.56)

16. Sagittal
CMS-1500
3 (ex 311)
Vertical plane dividing the body to the left and the right sides.
Vagina

17. neo
The fractured area of the bone collapses on itself.
Turning the palm or foot upward
Under
New

18. What is secondary malignancy?
Bursting forth blood
Below
Separation - Breakdown
Cancer that has spread to a secondary site.

19. Who does TRICARE cover?
Active - retired - survivors and their families of the Armed Forces.
Moving forward
Governed by State and Local laws; should be retained indefinitely. For deceased patients - they should be kept at least 5 years.
Blood Condition

20. -emia
Blood Condition
1. The amount of time - intensity of effort and medical skill required for the service 2.Overhead; the practice costs related to performing the service 3. Cost of Medical Malpractice insurance
Shin
Movement away from the midline

21. -rrhagia
Bursting forth blood
Under
Toe Bones
Birth

22. How many digits does an ICD-9 Category code have?
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. History -Chief complaint -History of Present illness -Review of Symptoms -Past - Family and Social History 2. Physical Exam 3.Medical Decision Making Complexity
1. History -Chief complaint -History of Present illness -Review of Symptoms -Past - Family and Social History 2. Physical Exam 3.Medical Decision Making Complexity
3 (ex 311)

23. epi
In front of the temporal bones
Absence of hair
False
Above

24. What are the 2 types of glands on the skin?
Upper Back
1. Sebaceous (oil) glands 2. Suddiferous (sweat) glands
Noninvasive - non-spreading - nonmalignant.
Nose

25. mast/
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.
Lung
Upper Back
Breast

26. How long should Medical Records be retained?
Governed by State and Local laws; should be retained indefinitely. For deceased patients - they should be kept at least 5 years.
1. Sebaceous (oil) glands 2. Suddiferous (sweat) glands
Finger Bones
Side

27. What are the 5 regions of the spine?
Four
Standards of conduct based on moral principals.
An insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
1. Cervical 2. Thoracic 3.Lumbar 4. Sacral 5. Coccygeal

28. How is the Patients DOB entered on the claim form?
4. (ex 311.0)
MM/DD/YY
Lung
Initiative developed by CMS to promote national correct coding methods and control improper coding that leads to wrong payments of Part B health claims.

29. hin/
Initiative developed by CMS to promote national correct coding methods and control improper coding that leads to wrong payments of Part B health claims.
Separation - Breakdown
Nose
A pregnant woman who has had at least one pregnancy.

30. Radius
Interior of the nose
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.
Lower arm bone in line with the thumb
4. (ex 311.0)

31. What is a compression fracture?
Four
Lower Back
Movement away from the midline
The fractured area of the bone collapses on itself.

32. Distal
Gall bladder
Far from the point of attachment of the trunk.
A working diagnosis that has not yet been established.
To cut into

33. Inversion
Intestine
Turning Inward
Disease Condition
Measure

34. What is primary malignancy?
The original cancer site. Malignant tumores are considered primary unless documented as secondary or metastatic.
Skull - Ribcage and Spine.
Abdomen
Vertical plane dividing the body into Anterior and Posterior sections.

35. How many digits does an ICD-9 Category code have?
Bursting forth blood
Turning the palm or foot upward
Surgical Procedure Performed -Local infiltration/metatarsal/digit block/anesthesia -Pre-Op E/M services on day before surgery -Immediate Post-Op care -Normal - uncomplicated Post-Op care
3 (ex 311)

36. Frontal Bone
Physicians are legally responsible for their actions and their employee's actions. a.k.a Respondant Superior. (Let the master answer.)
Forms the front part of the skull and the forehead.
Near the point of attachment to the trunk.
Surgical Fixation

37. Macule
1. Malignant (Accelerated and severe) 2. Benign (Mild or controlled) 3. Unspecified (Not specified in the Medical Record)
1996
Discolored - flat lesion
Turning Outward

38. para
Epinephrine and Steriods
Within
Beside
Upper roof of the mouth

39. What is a Comminuted Fracture?
The bone is crushed or shattered.
Lower medial arm bone
MM/DD/YY
Hardening

40. What are synovial joints?
Half
Measure
Free moving joints that are surrounded by joint capsules.
Shoulder - collar - pelvic - arms and legs.

41. -centisis
Surgical Puncture
Smooth - slightly elevated swollen area that is redder or paler than the surrounding skin
Fibrous bands of ligaments
Inflammation

42. How are bones categorized?
The Axial Skeleton and the Appendicular Skeleton
The bone is broken and pierces an organ.
Abdomen
5. (ex 311.56)

43. What is a Colles Fracture?
A break at the distal end of the bone - usually when someone tries to break their fall.
Lower arm bone in line with the thumb
Physicians are legally responsible for their actions and their employee's actions. a.k.a Respondant Superior. (Let the master answer.)
Slow

44. What is Carcinoma in situ?
Cancer that has localized and not spread at all.
1. Eccrine (secrete odor) 2. Apocrine (odorless sweat)
To cut into
A pregnant woman who has had at least one pregnancy.

45. Zygoma
Ovary
Middle of the foot bone
Cheek Bone
4. (ex 311.0)

46. What is the False Claims Act (FCA)
1. Epidermis (Top layer) 2. Dermis (Middle layer) 3. Subcutaneous Layer
Cheek Bone
A Federal law that prohibits submitting a false claim or making a false statement or representation in connection with a claim.
CMS-1500

47. -rrhea
Discharge - Flow
Under
Birth
Provides medical benefits to spouses and children of veterans with total - permanent - service related disabilities- or have died.

48. Flat Bones
Milk
Head
Bones covering body parts (ie shoulder blades - ribs - pelvic bones)
Nose

49. Maxilla
Bones covering body parts (ie shoulder blades - ribs - pelvic bones)
Upper Jawbone
Lower Back
Against

50. Posterior/Dorsal
A new procedure or service since the previous edition.
Protection against loss of money caused by failure through error or unintentional omission of the individual or service submitting the claim.
5. (ex 311.56)
Back part of the body.

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Medical Coding Basics

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