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Medical Coding Basics

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. Zygoma
Mass
Date of Service (DOS) -Place of Service (POS) -Type of Service (TOS) -Diagnosis -Procedure(s)
Cheek Bone
Toe Bones

2. arth/
Cartilage
Smooth - slightly elevated swollen area that is redder or paler than the surrounding skin
Suture
Through

3. What is the Civil Monetary Penalties Law (CMPL)?
Through
Shoulder - collar - pelvic - arms and legs.
Milk
A law passed by the Federal Government to prosecute cases of Medicaid fraud.

4. -emia
Blood Condition
Governed by State and Local laws; should be retained indefinitely. For deceased patients - they should be kept at least 5 years.
In the cause of injury - poisoning - accidents or other adverse effects.
Surgical Repair

5. pseudo
False
Small collection of clear fluid; blister
Active - retired - survivors and their families of the Armed Forces.
Above

6. -scopy
To view
Record
Small with irregular shapes (ie wrist and ankle)
Without

7. Carpals
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.
Office of Inspector General (OIG)
Wrist bones
Forms the two lower sides of the cranium

8. What is Assignment of Benefits?
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.
Reimbursement is sent directly from payer to the provider.
1. Epidermis (Top layer) 2. Dermis (Middle layer) 3. Subcutaneous Layer
1. Volume 1; Tabular List 2. Volume 2; Diseases - Alphabetic Index 3. Volume 3; Procedures - tabular list and index

9. ex
Toe Bones
Heart
Forms the sides of the cranium
Out - out of

10. hin/
Smooth - slightly elevated swollen area that is redder or paler than the surrounding skin
Far from the point of attachment of the trunk.
Stone
Nose

11. When are V codes used?
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
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
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
4. (ex 311.0)

12. Sagittal
Vertical plane dividing the body to the left and the right sides.
Through
Treatment
Uteris

13. arth/
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
Cartilage
Upper Arm bone
Bones at the corner of each eye that cradle the tearducts

14. chondro/
Upper Jawbone
Cartilage
Forms the sides of the cranium
Strong - broad and have large surfaces for muscles to attach to.

15. -plasty
Horizontal plane dividing the upper and lower parts of the body.
Below
Surgical Repair
Cancer that has localized and not spread at all.

16. Metacarpals
A pregnant woman who has had at least one pregnancy.
To cut into
Bones the palm of the hand
Provides medical benefits to spouses and children of veterans with total - permanent - service related disabilities- or have died.

17. What is the name of the claim form that is standard for submitting claims?
Separation - Breakdown
Lower Back
CMS-1500
The Axial Skeleton and the Appendicular Skeleton

18. What are the two types of edits that the NCCI implements?
Ovary
Before
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.
Social and Medical History -Family History -Physical Exam Findings -Progress Notes -Lab/Rad Results -Consultation Reports -Correspondence to the patient

19. What is a Colles Fracture?
A change in the code description since the last edition.
A pregnant woman who has had at least one pregnancy.
Below
A break at the distal end of the bone - usually when someone tries to break their fall.

20. What are the two provisions of HIPPA?
1. Insurance Reform 2. Administrative Simplification
Ankle
4. (ex 311.0)
Small collection of clear fluid; blister

21. Macule
Discolored - flat lesion
Forms the two lower sides of the cranium
1. Insurance Reform 2. Administrative Simplification
Bone that forms the wall between the nostrils

22. Phalanx
Lower arm bone in line with the thumb
Fallopian tubes
Intestine
Toe Bones

23. Protraction
Upper Jawbone
Active - retired - survivors and their families of the Armed Forces.
Initiative developed by CMS to promote national correct coding methods and control improper coding that leads to wrong payments of Part B health claims.
Moving forward

24. dys
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
Painful - difficult
26
Hind foot bone

25. cholecyst/
5. (ex 311.56)
Gall bladder
Vertical plane dividing the body into Anterior and Posterior sections.
Hematopoietic tissue

26. oste/
Bone
Vagina
4. (ex 311.0)
Bursting forth blood

27. oglio
MM/DD/YY
Gall bladder
Little - scanty
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

28. Can you have TRICARE and CHAMPVA at the same time?
No.
Head
Small - rounded bones that resemble sesame seeds that are found near joints. (ie knee cap)
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.

29. Lumbar
Surgical Fixation
Pain
The bone is broken and pierces an organ.
Lower Back

30. Anterior/Ventral
1. Epidermis (Top layer) 2. Dermis (Middle layer) 3. Subcutaneous Layer
Interior of the nose
Front part of the body.
Head

31. What are the two provisions of HIPPA?
Half
1. Insurance Reform 2. Administrative Simplification
Enlargement
5. (ex 311.56)

32. cardi/
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.
Physicians are legally responsible for their actions and their employee's actions. a.k.a Respondant Superior. (Let the master answer.)
Heart
Movement toward the midline

33. Temporal Bones
Toe Bones
Slow
Upper Arm bone
Forms the two lower sides of the cranium

34. Who does TRICARE cover?
Blood Condition
Active - retired - survivors and their families of the Armed Forces.
Intestine
1. History -Chief complaint -History of Present illness -Review of Symptoms -Past - Family and Social History 2. Physical Exam 3.Medical Decision Making Complexity

35. Carpals
Suture
Wrist bones
Moving backward
Many

36. What are the key components of E/M?
1. History -Chief complaint -History of Present illness -Review of Symptoms -Past - Family and Social History 2. Physical Exam 3.Medical Decision Making Complexity
Birth
1. Malignant (Accelerated and severe) 2. Benign (Mild or controlled) 3. Unspecified (Not specified in the Medical Record)
Smaller - lateral leg bone

37. brady
Discharge - Flow
Strong - broad and have large surfaces for muscles to attach to.
Slow
Through

38. Occipital Bone
Forms the back of the skull
Standards of conduct based on moral principals.
Breast
Out - out of

39. What is Carcinoma in situ?
Uteris
Inflammation
1996
Cancer that has localized and not spread at all.

40. 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.
Stomach
Removal - Excision - Resection
Far from the point of attachment of the trunk.

41. What are synovial joints?
Free moving joints that are surrounded by joint capsules.
Side
Standards of conduct based on moral principals.
Before

42. What are Medical Ethics?
Before - in front of
Vertical plane dividing the body to the left and the right sides.
Date of Service (DOS) -Place of Service (POS) -Type of Service (TOS) -Diagnosis -Procedure(s)
Standards of conduct based on moral principals.

43. -meter
Forms the front part of the skull and the forehead.
Lower Back
Measure
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

44. Parietal Bones
Forms the sides of the cranium
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.
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
Ankle

45. Proximal
Through
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.
In front of the temporal bones
Near the point of attachment to the trunk.

46. When are E codes used?
Forms the back of the skull
In the cause of injury - poisoning - accidents or other adverse effects.
Lower arm bone in line with the thumb
Mass

47. Maxilla
Toe Bones
A pregnant woman who has had at least one pregnancy.
Sacrum
Upper Jawbone

48. What are synovial joints?
4. (ex 311.0)
Free moving joints that are surrounded by joint capsules.
Nose
Absence of hair

49. Ethmoid Bone
Within
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.
Bones the palm of the hand
Forms the roof of the nasal cavity

50. oglio
In front of the temporal bones
Mouth
Slow
Little - scanty