CMA AAMA ADM+

What is the UB-04 also known as?

The CMS-1450 or the Uniform Bill 04.

Volume I of the ICD-9 is also known as?

The Tabular List (list all diagnostic codes in numeric order)

What does CPT stand for?

Current Procedural Terminology

A group of procedures associated with a diagnosis is called?

DRG

What is HCPCS used for?

Developed by Medicare as a supplement to the CPT system for procedures not defined with sufficient specificity.

What is the CPT system used for?

Developed by the AMA to convert commonly accepted descriptions of medical procedures into a five-digit numeric code with two-digit modifiers when required. Used to code medical procedures.

What is the ICD-9-CM used for?

Developed by the WHO to classify all known diseases to assist in maintaining statistical records of morbidity (sickness) and mortality (death). Used for both diagnostic and procedure coding. Currently consists of a three-digit code with one or two numeric modifiers. The modifiers are separated from the three-digit code by a decimal point. Updated yearly.

A check that the bank refuses to pay is?

Dishonored

The MA is asked to instruct the patient on the proper collection of a stool specimen for fecal occult blood testing. What is a good example of instruction for the patient?

Do not eat red meat or beets for about 48 hours before collection. (Can result in a false-positive)

What is the proper place to start in the CPT codebook when looking up a code?

The index.

Funds legally removed from a practice for personal use are often classified as?

Drawing

An obligation to act in certain ways is a?

Duty

The process of converting meaning into understandable symbols is known as?

Encoding

Triple Option Plan, a type of Managed Care Organization (MCO), entails?

Enrollees have the option of traditional, HMO, or PPO health plans.

What are E/M codes, and what are they used for?

Evaluation and management. Takes every possible combination of visits into consideration and assigns each its own number. (in/new patient)

EPO, a type of Managed Care Organization (MCO), stands for?

Exclusive Provider Organizations (enrollees must obtain their medical services from a network of providers or health care facilities that are under exclusive contract to the EPO.

Deliberately communicated consent is?

Express consent

What are E codes?

External Causes of Injury (injury or poisoning)

What insurance provides coverage on a fee-for-service basis?

Traditional insurance

Blue Cross and Blue Shield are policies offered under what type of insurance?

Traditional or independent

A special check prepared when a personal check may not be accepted or where carrying cash is not prudent is a?

Traveler's check

The medical abbreviation meaning before meals is?

a.c.

A prepaid health plan that emphasizes health prevention and promotion is?

HMO

HMO, a type of Managed Care Organization (MCO), stands for?

Health Maintenance Organization (Enrollees obtain medical services from a network of providers who agree to fixed fees for services but are not under exclusive contract to the insurance carrier)

A RBC index that measures RBC volume is?

MCV (mean corpuscular volume)

Special characters that simplify the sorting and routing of financial documents are?

MICR

Negligence of a professional person is known as?

Malpractice (the failure of a professional person to use reasonable care or judgment in treatment of a case)

An insurance program that oversees the delivery of services to ensure that care is appropriate, necessary, and cost-effective is called?

Managed care

Title 19 of the Social Security Act best describes?

Medicaid

Lawrence Kohlberg is associated with?

Moral development

When referencing codes, what does NEC mean?

Not elsewhere specified

When referencing codes, what does NOS mean?

Not otherwise specified

What two-digit modifier indicates an unusual procedural service?

-22

What two-digit modifier indicates a bilateral procedure?

-50

What two-digit modifier indicates multiple procedures?

-51

What three-digit code is used before a modifier code to make it a full five-digit code?

099

When using a typerwriter to complete a preprinted form, elite pitch consists of what number of characters per inch?

12

COBRA requires that government claim forms and attachments be maintained for at least _____ years?

5 years

What number of lines of text represent 1 inch?

6

Five-digit CPT codes used for unlisted services end in?

99

What is the amount of money that the insured must incur for medical services before the policy begins to pay called?

A deductible.

What would be an example of the concept res ipsa loquitur?

A health care provider leaves a sponge in a patient's body cavity during surgery. (Phrase translates to "the thing speaks for itself")

Volume III of the ICD-9 contains what information?

A list of procedures in tabular form. Used to classify inpatient procedures performed and billed by hospitals.

The intramuscular injection site for the mid-deltoid area is bounded on the bottom by?

A point opposite the axillary region.

What does the + symbol before a CPT code indicate?

A procedure is an add-on to a previously describe procedure.

According to ICD-9-CM coding conventions, malignant hypertension is?

A severe form with vascular damage

What does TRICARE insurance cover?

Active duty, activated guard, reserves, retired members of the military, and their families and survivors.

Volume II of the ICD-9 contains what information?

An alphabetic listing of all known diagnoses (Index to Diseases). It includes symptoms, accident and their causes, and concurrent diagnosis. Also contains a table of drugs and chemicals, a neoplasm table, and a list of external causes for injuries.

If a medical assistant is served with a subpoena duces tecum, what is the medical assistant legally required to do?

Appear in court with records on the date indicated (subpoena duces tecum translates to under penalty, you shall bring it with you)

The ICD Classification of Drugs by AHFS is?

Appendix C

The ICD Glossary of Mental Disorders is?

Appendix D

AOB means?

Assignment of benefits

The surgery section in the CPT codebook separates codes into _________?

Body systems, starting with the skin, and ending with ocular and auditory systems. Codes are very specific.

To start looking for a CPT code, where do you start in the codebook?

Category I section and select the general classification of the procedure being coded (ex. radiology, surgery, etc.)

A check the bank authenticates and guarantees by setting aside the funds until it is presented for payment is a?

Certified check

What was TRICARE formerly known as?

Civilian Health and Medical Program for Uniformed Services (CHAMPUS)

What is CHAMPVA?

Civilian Health and Medical Program of the Veterans Administration (medical insurance for spouses and unmarried dependent children of a veteran with permanent total disability resulting from a service-related injury and for the surviving spouse and children of a veteran who died of a service-related disability)

An insurance policy designed to pay fees not covered by conventional plans is a?

Companion plan

What does HCPCS stand for?

Healthcare Common Procedure Coding System

The abnormal hemoglobin molecule responsible for sickle cell anemia is?

Hemoglobin S

A gratuitous payment for professional services which custom or propriety forbids a price to be set is a?

Honorarium

What does Medicare Part A cover?

Hospital admission and stay, home health care, and hospice care.

Mimicking the behavior of another to cope with feelings of inadequacy is called?

Identification

What is the IPPS fee schedule system?

Inpatient Prospective Payment System (A reimbursement system for hospitals based on similar diagnostically related groups (DRGs) of inpatients discharged.)

The proofreading mark ^ means?

Insert

IDSs, a type of Managed Care Organization (MCO), stands for?

Integrated Delivery Systems (Enrollees obtain medical services from an affiliated group of service providers)

What does ICD-9-CM stand for?

International Classification of Diseases, 9th Revision, Clinical Modification

What is a UB-04 used for?

It is the standard form used for inpatient admissions, outpatient, and emergency department services and procedures, psychiatric facilities, drug and alcohol facilities, clinical and lab services, walk-in centers, nursing facilities, home health care agencies, hospice centers, and long-term care benefits under a health plan.

The data entered into a spreadsheet comprising alphanumeric characters primarily used as column and headings is known as the?

Label

When coding using HCPCS, what basic system is used?

Levels (I, II, and III)

When scheduling appointments, what is least important to consider?

Location of the clinic

What is the OPPS fee schedule system?

Outpatient Prospective Payment System (A reimbursement system for hospital outpatients, certain Part B services furnished to hospital inpatients who have Part A coverage, and partial hospitalization services furnished by community mental health centers)

What does Medicare Part B cover?

Outpatient expenses including providers' fees, physical therapy, lab tests, radiologic studies, ambulance services, and charges for durable medical equipment.

POS, a type of Managed Care Organization (MCO), stands for?

Point-of-Service Plan (Enrollee has the freedom of obtaining medical services from an HMO provider or by self-referral to non-HMO providers)

PPO, a type of Managed Care Organization (MCO), stands for?

Preferred Provider Organization (Enrollees obtain services from a network of providers and hospitals that have contracted their services at a discounted fee to an insurance company on a nonexclusive basis)

What does Medicare Part D cover?

Prescription drugs

What does Medicare Part C cover?

Private advantage plans.

Erik Erikson is associated with?

Psychosocial development

An unconscious defense mechanism characterized by behavior that is the opposite of one's true feelings describes?

Reaction formation

First-class mail that is insured is..?

Registered mail.

What does RBRVS stand for?

Resource-based relative value scale (a fee schedule developed by Medicare that used values for each medical and surgical procedure based on work, practice, and malpractice expenses and is factored for regional differences)

The loss of income resulting from an illness interferes with what patient need?

Safety need (income is most closely associated with safety need and freedom from anxiety)

Which of the schedules of drugs is the most closely regulated by the Drug Enforcement Agency?

Schedule II (have the most potential for abuse and dependency)

In Maslow's Hierarchy of Needs, the need to be respected describes the need for?

Self-esteem

Reference notation comes right after the?

Signature line

What are V codes?

Supplementary Health Factor Codes. Used for when patient comes to the medical facility for a reason other than sickness or injury.

Advanced directives must be initialed and signed by?

The patient

What is a UCR fee?

Usual, customary, and reasonable fee schedule (defines allowable charges that will be accepted by insurance carriers. Rate may vary from one carrier to another, but the process is the same)

Which of the following codes best characterizes a HCPCS Level II code? A. 64501 B. 45521-50 C. V8899 D. 32245-22 E. V4995

V4995

An example of a Schedule IV drug is?

Valium

Which vitamin is considered a potent antioxidant?

Vitamin E

When using the ICD-9-CM, where would you start to look up a code?

Volume II

A purchase agreement provision that covers the cost of repair resulting from faulty design or manufacturing is a?

Warranty

Scheduling the number of patients that can be seen in 1 hour based on the average appointment describes the?

Wave system

For nonparticipating Medicare providers, the patient....

pays the provider