medical billing & coding
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| Three, four and five digit codes are considered? | show 🗑
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| Terms indented two spaces to the right below the main term are called? | show 🗑
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| The Neoplasm table found in the Index under main term "Neoplasm" and is organized by anatomic site, what are the categories of neoplasm? | show 🗑
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| show | Index to diseases, table of drugs and chemicals, index to external causes of injuries
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| What does HCPCS stand for? | show 🗑
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| Level I HCPCS codes are? | show 🗑
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| A bullet (.) represents? | show 🗑
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| Evaluation and Management begins with? | show 🗑
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| show | section 77
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| Eligibility of Medicaid is divided into two classifications? | show 🗑
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| Five types of benefits offered to workers compensation beneficiaries? | show 🗑
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| Champva was created to provide medical benefits to? | show 🗑
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| show | is called the superbill, it is a listing of the diagnosis,procedures,and charges for a patients visit
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| show | means Pain
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| What does -megaly mean? | show 🗑
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| show | means inflammation
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| What does -ectomy mean? | show 🗑
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| What are HCPCS? | show 🗑
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| Level II HCPCS codes are? | show 🗑
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| show | A letter followed by four numbers
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| show | evaluation & management, anesthesia, surgery, radiology, pathology & laboratory, medicine, category II codes and category III codes
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| When are category II codes published (CPT)? | show 🗑
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| show | represents services and procedures widely used by health professionals
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| show | supplemental codes used for performance measurements
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| show | temporary codes for emerging technology, services and procedures
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| A triangle in () represents? | show 🗑
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| Two triangular symbols(><) represents? | show 🗑
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| show | 80
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| show | 10
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| show | a document provided to a Medicare beneficiary prior to service being rendered and letting them know of his/her responsibility to pay if the claim is denied.
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| Tricare is? | show 🗑
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| What is coordination of benefits (COB) | show 🗑
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| Coinsurance is? | show 🗑
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| What does -emia mean? | show 🗑
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| show | means Disease Process Condition
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| show | means Tumor
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| What does -pexy mean? | show 🗑
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| What does -stomy mean? | show 🗑
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| show | means incision
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| What does -plasty mean? | show 🗑
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| What does Hemat mean? | show 🗑
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| What does Hemi mean? | show 🗑
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| show | means cartilage
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| show | means fallopian tube
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| show | means muscle
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| show | means stomach
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| show | means bone
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| show | means heart
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| What does hyster mean? | show 🗑
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| show | means benign growth in the mucous membrane
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| What does ulcer mean? | show 🗑
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| show | means a pregnant woman who has had at least one previous pregnancy
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| Which fee schedule method is used mostly in reference to fee-for-service reimbursement? | show 🗑
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| show | Claims made insurance
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| A type of managed care plan regulated under insurance statutes combining features of health maintenance organizations and preferred provider organizations that employers agree not to contact with any other plan is known as? | show 🗑
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| show | Co-payments
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| HMO's and preferred provider organizations consisting of a network of physicians & hospitals that provide & insurance company or employer with discounts on their services are referred to collectively as? | show 🗑
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| show | Epilepsy
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| The process of discovering whether a treatment is covered under a patients contract called? | show 🗑
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| show | deductible
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| A physician who controls patient access to specialists and diagnostic testing services is called a? | show 🗑
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| show | an evaluation of the quality and efficiency of services provided by a physician
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| show | OT/O
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| show | supine
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| show | PATHO is, not OPSY, CENTESIS or RETRO
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| show | Orthopedist
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| Which of the following terms below means "through"? | show 🗑
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| show | adjective suffixes meaning "pertaining to"
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| show | Call the patient's physician to obtain the date of injury
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| What type of claim is any Medicare claim that contains complete, necessary information but is illogical or incorrect? | show 🗑
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| The collection ratio is? | show 🗑
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| What is defined as reimbursement for income lost as a result of a temporary or permanent illness or injury? | show 🗑
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| What is a policy that covers losses to a third party caused by the insured, by an object owned by the insured, or on premises owned by the insured? | show 🗑
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| What is the organ that secretes hormones, epinephrine and steroids? | show 🗑
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| show | Work cost is the amount of time, intensity of effort, & medical skill required of the physician. Overhead cost represents the practice costs related to the performing of the service. Malpractice cost represents the cost of medical malpractice insurance
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| Code 11 listed on the claim form is for? | show 🗑
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| A policy that will respond to incidents originating from the coverage period regardless of when the claim was reported is known as? | show 🗑
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| Assignment of benefits is? | show 🗑
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| Accept assignment means? | show 🗑
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| A deductible is? | show 🗑
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| show | is the cost of the insurance coverage paid annually, semi-annually or monthly by the policy holder before benefits will be paid
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| What is the process of converting diagnosis, procedures, and services into numeric and alphanumeric characters? | show 🗑
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| show | itemized statement
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| show | as a dollar amount
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| show | Therapeutic Use
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| Information required to show that insurance was billed should include? | show 🗑
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| show | stand-alone codes
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| show | E Codes
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| Supplementary classification codes used to identify health care encounters that occur for reasons other than illness or injury or to identify patients whose illness is influenced by special circumstances of problems is? | show 🗑
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| show | Synovial joint
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| There are three layers to the skin? | show 🗑
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| show | every year in the month of October
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| Terms indented two spaces to the right below the main term are called? | show 🗑
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| show | history, physical exam, medical decision making
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| HCFA became the? | show 🗑
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| show | clean, dirty, invalid, rejected
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| A "clean claim" means? | show 🗑
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| In E/M coding, selection of a code, this is only considered as supplementary? | show 🗑
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| show | malignant, benign and unspecified
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| In the CPT manual, a triangle in () means? | show 🗑
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| show | history, examination, medical decision making
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| To correct documentation in a patients file, you would? | show 🗑
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| Intentionally deceiving or misrepresenting by either provider or beneficiaries to obtain payment for services is referred to? | show 🗑
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| show | An established patient
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| In the ICD-9CM volume 2, a subterm that is contained within parenthesis () indicate? | show 🗑
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| show | malignancies that are confined and noninvasive
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| Peer review is an evaluation of? | show 🗑
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| In the CPT, what does the (+) symbol represent? | show 🗑
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| ICD-9-CM (volume 2) indicates? | show 🗑
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| The alphabetical index contains three sections? | show 🗑
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| show | primary, secondary, carcinoma in situ, uncertain behavior, unspecified nature
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| To code accurately, it is essential to always code a ICD-9CM code ultimately from? | show 🗑
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| In the CPT, what does the bullet symbol (.) mean? | show 🗑
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| What does HCPCS stand for? | show 🗑
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| show | 2 levels
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| show | a collection of codes for procedures, supplies, products and services that provides to insurance beneficiaries
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| show | 5 position numeric codes
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| show | 5 position alpha-numerical codes
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| CPT manual is composed of how many sections? | show 🗑
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| show | WHO
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| show | New Patient
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| Which statement sent by the payer to the covered individual contains reimbursement amounts and an explanation in an easy-to-read format? | show 🗑
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| The patients birthday on the CMS-1500 form is entered in which of these formats? | show 🗑
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| show | An itemized statement
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| ICD-9-CM is the? | show 🗑
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| show | High Income earners
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| A respirator used by a Medicare patient is an example of? | show 🗑
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| show | Serivce and procedure based
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| show | Medicaid
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| What is a pre-existing condition? | show 🗑
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| All of the following are correct regarding add-on codes, except? | show 🗑
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| A situation that is considered "abuse" and not "fraud" is? | show 🗑
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| show | Eponym
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| show | HCPCS, Level II
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| "CCI" stands for? | show 🗑
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| In the medical field, medical ethics are considered? | show 🗑
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| A "Medigap" policy indicates? | show 🗑
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| show | Reciprocity
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| The act that was passed to protect individuals who stop to render aid to an accident victim is called? | show 🗑
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| show | an employer ID number (EIN)
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| A patient develops a rash after taking a properly prescribed medicatin. The E code to be used to indicate how the rash happened is referenced from which E code column in the Table of Drugs and Chemicals? | show 🗑
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| show | Capitation
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| When looking up a diagnosis code, you will first begin with? | show 🗑
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| Under the RBRVS method of reimbursement, conversion factor could be described as? | show 🗑
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| Which of the following describes a combining form? | show 🗑
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| show | HIPPA
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| show | colostomy
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| Federal Law that prohibits submitting a fraudulent claim or making a false statement in connection with a claim is? | show 🗑
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| show | Centers for Medicare and Medicaid Services (CMS)
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| What does hysterectomy mean? | show 🗑
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| show | Neurologist
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| E codes are supplementary classification codes used to? | show 🗑
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| show | Synovial joint
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| There are three layers to the skin? | show 🗑
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| show | Index to diseases, table of drugs and chemicals, index to external causes of injury
🗑
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| show | Stand-alone codes
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| show | The physicians national provider ID number
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| show | E codes
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| show | reimbursement is directly sent from the payer to the provider
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| Accept assignment means? | show 🗑
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| A policy that will respond to incidents originating from the coverage date regardless of when the claim was reported is known as? | show 🗑
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| show | clean claims
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| Nutrient rich blood is returned back to the atrium through the? | show 🗑
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| The maxilla, cranium, and axille is all part of the? | show 🗑
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| Interneurons connect senssory and motor neurons within the? | show 🗑
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| show | modifier 50
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| When physicians, hospitals and other healthcare providers contract with one or more HMO's or directly with an employer to provide care, this is called? | show 🗑
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| show | HMO
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| Charges a higher premium in exchange for more flexibility? | show 🗑
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| A policy that will cover incidents originating on or after the policy retroactive date is known as? | show 🗑
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| show | work cost representing the amt of time, intensity of effort, and medical skill required of the physician, overhead cost representing the cost related to the performing of svcs, malpractice cost representing the cost of medical malpractice insurance
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| show | place of service
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| show | changes in the text or definition between the triangles
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| circle with slash represents exemption from? | show 🗑
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| show | adrenal gland
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| Which of the following refers to a patient that is without pain? | show 🗑
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| show | ears, nose and throat
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| What are the 4 various terms used to describe the state of submitted forms? | show 🗑
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| show | invalid claim
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| show | American Health Organization
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| show | subterms
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| show | Participating provider
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| Indented codes are? | show 🗑
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| show | Modifiers
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| Information required to show that insurance was billed should include? | show 🗑
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| Employer Liability is when physicians are legally responsible for their own? | show 🗑
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| show | Locate the code in the alphabet Index and then cross-reference the code in Volume I
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