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Medical Coding Basics

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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. Retraction
Moving backward
Upper roof of the mouth
Date of Service (DOS) -Place of Service (POS) -Type of Service (TOS) -Diagnosis -Procedure(s)
Visual Examination

2. supra
26
Forms the front part of the skull and the forehead.
Above
Record

3. What is the Civil Monetary Penalties Law (CMPL)?
An insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.
A law passed by the Federal Government to prosecute cases of Medicaid fraud.
Upper roof of the mouth
The Axial Skeleton and the Appendicular Skeleton

4. What are synovial joints?
Front part of the body.
To view
Free moving joints that are surrounded by joint capsules.
Bursting forth blood

5. How many regions is the spinal/vertebral column divided into?
A break at the distal end of the bone - usually when someone tries to break their fall.
Hind foot bone
Against
5

6. neo
1. Malignant (Accelerated and severe) 2. Benign (Mild or controlled) 3. Unspecified (Not specified in the Medical Record)
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
Out - out of
New

7. Frontal Bone
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
Upper roof of the mouth
Bones at the corner of each eye that cradle the tearducts
Forms the front part of the skull and the forehead.

8. lith/
Stone
Cancer that has spread to a secondary site.
Removal - Excision - Resection
Forms the roof of the nasal cavity

9. What is the name of the claim form that is standard for submitting claims?
A law passed by the Federal Government to prosecute cases of Medicaid fraud.
CMS-1500
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.
Abnormal condition

10. dys
The original cancer site. Malignant tumores are considered primary unless documented as secondary or metastatic.
Forms the sides of the cranium
New
Painful - difficult

11. What are bursae?
Pain
Under
1. History -Chief complaint -History of Present illness -Review of Symptoms -Past - Family and Social History 2. Physical Exam 3.Medical Decision Making Complexity
Sacs of fluid located in-between the bones of the joint and tendons that hold the muscles into place.

12. -oma
Physicians are legally responsible for their actions and their employee's actions. a.k.a Respondant Superior. (Let the master answer.)
Mass
1. Eccrine (secrete odor) 2. Apocrine (odorless sweat)
Skin

13. -tomy
To cut into
A change in the code description since the last edition.
Cartilage
Lower medial arm bone

14. Macule
Discolored - flat lesion
Above
A working diagnosis that has not yet been established.
Abdomen

15. salping/
Toe Bones
Between
Fallopian tubes
Lower medial arm bone

16. Inferior nasal conchae
Interior of the nose
MM/DD/YY
Reimbursement is sent directly from payer to the provider.
Forms the front part of the skull and the forehead.

17. How many volumes is the ICD-9 manual divided into?
1. Volume 1; Tabular List 2. Volume 2; Diseases - Alphabetic Index 3. Volume 3; Procedures - tabular list and index
Shoulder - collar - pelvic - arms and legs.
False
In front of the temporal bones

18. What does a triangle in the CPT book next to a code mean?
A change in the code description since the last edition.
Record
Reimbursement is sent directly from payer to the provider.
1. Cervical 2. Thoracic 3.Lumbar 4. Sacral 5. Coccygeal

19. Lipocyte
Fat cell
Nose
Fallopian tubes
Abnormal condition

20. Transverse/Cross Sectional
Provides medical benefits to spouses and children of veterans with total - permanent - service related disabilities- or have died.
Horizontal plane dividing the upper and lower parts of the body.
Finger Bones
Bones the palm of the hand

21. -rrhaphy
Suture
Osseous
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.
Below

22. Ulna
Date of Service (DOS) -Place of Service (POS) -Type of Service (TOS) -Diagnosis -Procedure(s)
Lower medial arm bone
Office of Inspector General (OIG)
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

23. Vomer
In front of the temporal bones
Skull - Ribcage and Spine.
Osseous
Bone that forms the wall between the nostrils

24. How is the Patients DOB entered on the claim form?
1. Malignant (Accelerated and severe) 2. Benign (Mild or controlled) 3. Unspecified (Not specified in the Medical Record)
Sacrum
MM/DD/YY
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

25. anti
Little - scanty
Inflammation
Pain
Against

26. brady
Forms the sides of the cranium
Slow
Skin
Date of Service (DOS) -Place of Service (POS) -Type of Service (TOS) -Diagnosis -Procedure(s)

27. Impetigo
CMS
Bacterial inflammatory skin disease with lesions - pustules and vesicles
Forms the two lower sides of the cranium
The Axial Skeleton and the Appendicular Skeleton

28. -emia
No.
Upper roof of the mouth
Blood Condition
Surgical Fixation

29. Who does TRICARE cover?
Karatin
Skin
Noninvasive - non-spreading - nonmalignant.
Active - retired - survivors and their families of the Armed Forces.

30. Posterior/Dorsal
Back part of the body.
The Axial Skeleton and the Appendicular Skeleton
CMS-1500
Disease Condition

31. 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.
Head
Fallopian tubes
Bones the palm of the hand

32. salping/
Death of tissue due to loss of blood supply
Fallopian tubes
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.
Half

33. What is the National Correct Coding Initiative (NCCI)?
Karatin
Discharge - Flow
Skin
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. Long Bones
Strong - broad and have large surfaces for muscles to attach to.
A new procedure or service since the previous edition.
Small with irregular shapes (ie wrist and ankle)
Little - scanty

35. Frontal - Coronal
Lunula
Osseous
Social and Medical History -Family History -Physical Exam Findings -Progress Notes -Lab/Rad Results -Consultation Reports -Correspondence to the patient
Vertical plane dividing the body into Anterior and Posterior sections.

36. hyster/
Cheek Bone
Uteris
Slow
Lung

37. Protraction
1996
Hardening
Bone
Moving forward

38. Lipocyte
1. Volume 1; Tabular List 2. Volume 2; Diseases - Alphabetic Index 3. Volume 3; Procedures - tabular list and index
Fat cell
A change in the code description since the last edition.
Below - deficient

39. Occipital Bone
Coccyx (Tailbone)
Stomach
Lower Back
Forms the back of the skull

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

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41. epi
Hematopoietic tissue
All
Above
Below

42. Can you have TRICARE and CHAMPVA at the same time?
Surgical Fixation
No.
Active - retired - survivors and their families of the Armed Forces.
Separation - Breakdown

43. Metatarsal
Movement away from the midline
Middle of the foot bone
Wrist bones
Against

44. How is Usual - Customary and Reasonable pricing calculated?

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45. ex
Through
Structural protein found in skin and connective tissue.
26
Out - out of

46. Frontal - Coronal
Vertical plane dividing the body into Anterior and Posterior sections.
Small collection of clear fluid; blister
Moving forward
A pregnant woman who has had at least one pregnancy.

47. Protraction
Moving forward
Date of Service (DOS) -Place of Service (POS) -Type of Service (TOS) -Diagnosis -Procedure(s)
Protection against loss of money caused by failure through error or unintentional omission of the individual or service submitting the claim.
1. Malignant (Accelerated and severe) 2. Benign (Mild or controlled) 3. Unspecified (Not specified in the Medical Record)

48. Thoracic
Upper Back
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
Under
Karatin

49. Ulna
Without
Lower medial arm bone
Forms the front part of the skull and the forehead.
Skull - Ribcage and Spine.

50. poly
Fallopian tubes
Lung
Epinephrine and Steriods
Many

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Medical Coding Basics

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