CMAA acronym list, CMAA #2, CMAA MOCK EXAM(1), CMAA2, CMAA # 2-Tech Center, CMAA Study Guide #2, MOAST CMAA Ch 7 Day 1 - Overview & Using Med Term & MT Ch 2, Medical Billing and Coding Part II-Cumulative Test - Chapters 16, 17, 18 and 19, Medical Ass...

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A deductible: a. is paid by the insurance company in full. b. is deducted from the payment owed the physician. c. is paid by the patient before insurance coverage pays for medical costs. d. is money owed the insurance company

c - Deductibles are set amounts of fees that will be the responsibility of the patient and are not covered by insurance. These fees usually have a limit and once that limit is reached, the insurance will then cover the difference

The following symbol (*): a. is used in the ICD-9 book to designate additional diagnoses. b. is found in the CPT book to designate revised guidelines for code use. c. designates variable pre and postoperative services. d. None of the above

c - Symbols used in the CPT coding manual are used to add additional information to procedural codes. The asterisk is used to note that services used with a particular code vary between pre- and postoperative services.

A document from an insurance carrier that tells the patient and the provider how the amount of the benefit was determined is the ____________. a. Utilization Review b. Basic medical c. Explanation of Benefits (EOB) d. Peer Review

c - The Explanation of Benefits or EOB is sent to the patient and to the provider, detailing how the benefit was determined based on the patient's particular health care plan.

What term is used when an insurance company makes a payment directly to a physician? a. Direct deposit b. Fee compliance c. Assignment of benefits d. Actual charges

c - The authorization to make payments directly to a physician by the insurance company is called an assignment of benefits. The patient has authorized his or her insurance company to pay the benefit to the physician.

In ICD-9, V codes are used to: a. Refer to specific conditions b. Refer to injury c. Refer to factors that influence health status d. Refer to external causes of injury

c - V codes are codes that refer to factors that influence health status. It is important in reporting medical necessity

*Cancer

carcin

Non-acute Care

care for patients who have chronic diagnoses

Short term care

care for patients who have diagnoses those health care workers can quickly resolve

Obstetricians

care for women who are pregnant and women who are in labor

etiology

cause of a disease

*cyt

cell

*Largest part of the brain

cerebr

Removal of gallbladder

cholecystectomy

*Thromb

clotting

An illness that existed before an insurance company because of the omission of:

complete diagnosis

infectious disease

contagious disease

examples of exclusions

cosmetic or plastic surgery for improving personal appearance, care/services delivered past a certain period of time, care or services that are not medically indicated, and care and services that are experimental

An electronic medical record software program can

create, store, edit, and retrieve a medical record

CPT

current procedural terminology - a uniform code that accurately describes and reports medical, surgical, and diagnostic services and procedures

An HMO is: a. a group model of managed care. b. a health model that emphasized preventative care. c. can be part of a group or a single organization. d. All of the above

d - HMOs are Health Maintenance Organizations. This type of managed care system is set up to emphasize well care to reduce the number of illnesses a patient suffers, which will lower the overall cost of the plan as a whole.

The CPT code for an office visit is: a. 88467 b. 44391 c. 12001 d. 99214

d - The CPT code for an office visit is 99214. An office or outpatient visit for the evaluation and management of an established patient requires detailed history, physical examination and medical decision making of moderate complexity

*Diagnosis

decision based on the information regarding the patient's history and the results of the doctor's examination

*Respiratory

delivers oxygen to cells remove carbon dioxide

*Skin

derm

Category II CPT

designed to serve as supplemental tracking codes that are used for performance measurement

itemized

detailed explanation of a medical bill; gives a line-by-line list of everything that was done and all the supplies and medications that were used

Itemized

detailed explanation of medical bill

chronic

developing slowly and/or lasting for a long time

Nephrologist

diagnose and treat kidney disorders

The procedure in which a scope is passed into the larynx so the physician can look at the larynx is what type of laryngoscopy?

direct

Emergency medicine physicians

disagnose and treat patients in emergency departments and they have skills in a variety of disciplines

The bulls-eye (dot within a circle)

displayed to the left of the code - includes moderate/conscious sedation bundled into the code.

DNR

do not resuscitate form - states a patient does not want to be revived if there are no signs of life

Notice of Privacy Practices

document informing a patient of when and how their PHI can be used.

*Policy

document that describes the insurance coverage for an individual or property

living will

document that spells out what kind of treatment a patient wants in the event that he can't speak for himself. AKA advanced directive

Advanced directive form

document that spells out what kind of treatment a patient. wants in the vent that he can't speak for himself. Also know as a living will.

Encounter form

document used to collect data about elements of a patient visit that can become part of a patient record can be used for management purpose. has pt. name, account number balance, cpt codes and diagnosis

bills

documentation of an obligation to pay

receipt

documentation of payment for goods or services

patient account

documents what services the office has provided to the patient, the charges for those services, the paid amounts, and the owed amounts

*Endocrine

effects changes through chemical messengers - pancreas thyroid

EDI

electronic data interchange - the transfer of electronic information in a standard format

HER

electronic health record - an electronic record of health-related information about a patient that conforms to nationally recognized interoperability standards that can be created, managed, and reviewed by authorized providers and staff from more than one health care organization

EMR

electronic medical record - an electronic medical record of health information that is created, added to, managed, and reviewed by authorized providers and staff within a single organization

Select the term that describes a procedure in which a scope is placed into a body cavity.

endoscopy

once the financial and health insurance forms are correct

enter them into your workplace's fianncial record system

*Above/upon

epi

essentially a RN with a master's degree. Similar to a PA

Allergists

evaluate and treat patients who have a disorder of the immune system

What is it called when the diaphragm is out of normal position and has moved up farther into the thoracic cavity?

eventration

EOB

explanation of benefits - a record of a patient's fees

traditional health insurance companies

exs. include preferred provider organizations (PPOs), point of service (POS) plans, and government-funded plans (such as Medicare and Medicaid)

The first step in choosing the correct digestive endoscopic procedure code is to identify the ____ of the procedure.

extent

The procedure used to develop an artificial opening through the abdominal wall is:

exteriorization

*Distal

far from the point of attachment to the trunk or far from the beginning of a structure

distal

farthest from the trunk

Medicare

federally funded health insurance for people age 65 or older, people younger than 65 who have certain disabilities, and people of all ages with end-stage kidney disease.

A gastrostomy tube is placed inside the stomach for:

feeding purposes

*Fetus

fet

*fetus

fet

*Sarc

flesh

if you have to send an overdue bill to a collection agency

follow the procedure your workplace has established for when to do this, who to notify and how to notify them

if the patient still has not paid the bill after this call

follow the protocol your office established for these situations (this could involve another call, a letter, or other options)

ASA Crosswalk book

for anesthesia coders; updated by the ASA annually

Health History Form

form that ask ps.to list any illnesses or surgeries that have had, family history, medications taken, chronic health issues, allergies and other physicians they consulted.

assignment of benefits (AOB) form

form that authorizes health insurance benefits to be sent directly to providers

front

*Ventral

front surface of the body starts with a V

*stomach

gastro

*Protein

globin

Medicaid

goveerenment-provided health insurance for the indigent or some people who have disabilities

Medicaid

government provided health insurance for the indigent or soem people who have disabilities

Medicare

government provided health insurance for the indigent or some people who have disabilities

Medicare

government-provided health insurance for older adults, retired individuals, and some people who have disabilities

*Process of recording

graphy

Healthcare Common Procedure Coding Systems (HCPCS)

group of codes and descriptors used to represent health care procedures, supplies, products, and services.

The Truth in Lending Act

has a specific regulation that governs credit and installment payments and physician services

Hospitalists

have primary responsibility for inpatients in a hospital

when Medicare covers a patient, but does not cover the services

have the patient the Medicare Waiver, also called the Advanced Beneficiary Notice (ABN)

HIE

health information exchange - system that enables the sharing of health-related information among providers according to nationally recognized standards

birthday rule

health plan of the parent whose birthday comes first in the calendar year is designated as the primary plan

*Cardio

heart

within 30 days of receipt

how long provider's expect patients, businesses, and organizations to pay bills within

*Excessive

hyper

perpetual transfer method

identifying files for purging by marking the outside of the file

always ask returning patients

if there is a change with their health insurance information since their last visit

idiopathic disorder

illness with unkown cause

The device that can be inserted into the body to electrically shock the heart into regular rhythm.

implantable defibrillator

physical status modifier

indicate the patient's condition at the time anesthesia was administered and identify the level of complexity of service; the modifiers all begin with P

anesthesia

induction or administration of a drug to obtain partial or complete loss of sensation

Bloodborne Pathogens

infectious microorganisms, such as HIV and Hepatitis

*itis

inflammation

in cases where the health insurance company does not cover services

inform the patient and have him/her sign documentation assuming financial responsibility

PHI or protected health information

information about health status or health care that can be linked to a specific individual.

Patient' social history

information about pt. lifestyle such as drinking, smoking and illegal drug use

*written form that states their understanding

informed consent

Advanced Beneficiary Notice (ABN)

informs the patient that Medicare may not pay for certain services

regional

interrupts the sensory nerve conductivity in a region of the body and is produced by a field block

*Enter

intestines

endotrachial

is accomplished by insertion of tube into the nose or mouth and passing the tube into the trachea for ventilation

*Inflammation

itis

*inflammation

itis

*Arthro

joint

*Nephr

kidney

*Ren

kidney

*Urinary

kidneys, bladder, urethras

common reasons for non-payment

lack of funds; medical or family emergency that is absorbing all of the patient's time; a dispute over perceived unfairness of the bill; or a case where the patient has never received the bill

sequela

late effect - condition that results from an injury or disease

*bi

life

What word describes a lymphadenectomy in which only the lymph nodes are removed?

limited

*Hepat

liver

*Cardiovascular

lymph glands, heart vessels / transportation

*Cardiovascular

lymph glands, heart vessels/transportation

*Certified Mail

mailing gives the sender the option to receive proof of delivery

*Bulk Mailing

mailing large volumes of information which is presorted by zip code

new patients

make sure they complete any financial and health insurance forms; you can mail these forms to the patient and he/she can bring them to the office at the time of his/her appointment, or he/she can fill them out when he/she arrives at the office

A program designed for certain needy and low income people, the blind, the disabled and members of family of family receiving aid to dependent children is called

medicaid

*viscera

medical term for internal organs

Which is an example of a third-party payer?

medicare

*Instrument to measure

meter

The record of the proceedings of a meeting is referred to as the:

minutes

expenses

money that a business or organization spends for the purpose of operating

MAC

monitored anesthesia care

NPI

national provider identifier - a unique 10-digit code for providers required by HIPAA

proximal

nearest the trunk

stat referral

needed in an emergency situation and can be approved immediately over the telephone after the utilization review has approved the faxed document.

*rhin

nose

moribund patient

not expected to live

health insurance companies

often referred to as third-party payers; agree to pay for a patient's health care costs, such as medications, hospital stays, and physician fees, in exchange for monthly or yearly payments (premiums)

A physician specializing in the diagnosis and treatment of tumors is called a

oncologist

pricing for anesthesia add-on codes

only the base unit value of the add-on code is allowed; reported with the primary anesthesia code

coding for multiple surgical procedures

only the procedure with the highest base unit value is assigned

supplier's account

outlines the financial obligations and history the clinic or office has with the supplier; a record of the financial transactions with the supplier

*Dyna

pain

The word element algia, algesia means

pain

suffixes

parts that appear at END of some terms

prefixes

parts that appear at the BEGINNING of some terms

*Wave scheduling

patients scheduled for the same time and seen in the order they arrive

The most common color-coding system color codes the:

patients surname

qualifying circumstances

performed in emergency situations dealing with extremely young or extremely old (1-70)

guarantor

person or entity responsible for the remaining payment of services after insurance has paid

Guarantor

person or organization that has agreed to pay the bill for medical services

guarantor

person or organization that has agreed to pay the bill(s) for medical services

*Medial

pertaining to the middle or near the medial plane of the body

*Medial

pertaining to the middle or nearer the medial plane of the body

The appointment system of the office should take into account needs of the:

physician

A fee profile is derived from:

physician charges

*an implied contract

physician patient relationship

included in the anestheia CPT code

preoperative, intraoperative/intraservice (during surgery), and postoperative

POMR

problem oriented medical record - divides the medical record into 4 sections: database, problem list, treatment plan, progress note

purging

process of moving files from active to inactive status

functional disorder

produces symptoms for which no physiological or anatomical cause can be identified

to make sure you safely and securely share and store PHI

protect computer passwords; ensure you do not leave hard copies of patient charts unattended or in public areas; confirm that recipients received the charts or other information you mailed or emailed; check that computer screens with PHI are not visible to unauthorized people; store records in the proper place; and return records to the storage area if you are not using them

PHI

protected health information - information about health status or health care that can be linked to a specific individual

*Immune

protection

Neurologist

provide specialized care for patients who have a disease or disorder of the brain and/or nervous system

Geriatricians

provide specialized care to older adults

moderate (Conscious) sedation

provides a decreased level of consciousness that does not put the patient completely to sleep; respond to stimulation and verbal commands - trained observer must be present

This type of lymphadenectomy is the removal of the lymph nodes, glands, and surrounding tissues.

radical

double-entry bookkeeping

records each transaction in two places: the assets and liabilities accounts; allows the production of a balance sheet at any time

single-entry bookkeeping

records income and expenses

adjustments

represent any necessary changes in credits, debits or other financial information

*Reproductive

reproduction

RBRVS

resource-based relative value scale - a system that provides national uniform payments after adjustments across all practices throughout the country.

*nose

rhin

combining forms

root word

*Instrument to visually or aurally examine

scope

Active files

section of medical charges for patients current receiving treatment

inactive files

section of medical charts for pts. the provider has not seen for 6 months of longer

closed files

section of medical charts for pts. who have died, moved away or terminated their relationship with the physician

Billing

securing and processing money patients owe

billing

securing and processing money patients owe

ways to reduce the number of claim errors

set aside a dedicated area and perhaps a dedicated employee for claims processing; try to complete a form once you start

bill collection

should be an organized, methodical cycle

credit balance

shows that a patient, business, or organization paid more than it owed and therefore has a credit in the account

manifestations

signs and symptoms of a disease

Prognosis

similar to diagnosis - a prediction of the probable outcome of a disease or disorder

two commonly used bookkeeping systems

single-entry and double-entry

*State of/condition

sis

*Integumentary

skin, hair, and nails

Gastroenterologists

specialize in disorders of the stomach and intestines.

examples of expenses

staff salaries, medical liability insurance, medical supplies, medications, office equipment, telephone services, utilities and computer equipment

International Classification of Diseases (ICD) codes

standard codes for diseases, signs and symptoms

International Classification of Diseases (ICD) codes

standard codes for diseases, signs, and symptoms

Current Procedural Terminology (CPT) codes

standard codes used to designate procedures and tests

Current procedural terminology (CPT) Codes

standard codes used to designate procedures and tests

general

state of unconsciousness that is accomplished by the use of a drug or combination of drugs administered intramuscularly, rectally, intravenously or by inhalation

*gastro

stomach

*Gastrointestinal

stomach/intestines

*A new opening

stomy

Opthalmology

study of care and diseases of the eye

Emergency Medical Services (EMS)

system that is responsible for responding to community medical emergencies and treating and transporting injured or sick individuals to the appropriate health care service

when explaining fees to a patient

talk to him/her in a private area and know how to explain each part of the bill; have a copy of the patient's bill and the physician's fee schedule

*Dent

teeth

*dent

teeth

customary

term used to describe a provider's fee; denotes the fee is usual and acceptable

Customary

term used to descrive a providers fee

fees

the amount of money the health care facility or medical professional charges for services it delivers

Out of pocket

the amount of money the patient must pay for medical care

accounts receivable

the amount that patients or health insurance companies owe to a clinic, physician's office, or hospital

out of pocket

the amount the patient must pay for medical care

multiple surgeries performed under one anesthetic administration

the anesthesia code that represents the hights base value unit procedure is reported; time is from start to finish of all procedures

when the provider extends credit to the patient

the clinic or office has to perform a credit check; give the patient a copy of the Truth in Lending form and have him/her sign it

Premiums

the costs for health insurance

premiums

the costs for health insurance

what to document after calling about an overdue bill

the date and time you called, who you spoke to, what he/she said, and what payment arrangements the patient made

contracts

the delivery of insurance depends on these; health insurance companies agree to pay for the health care and services incurred by a patient in exchange for premiums; HMOs and medical professionals agree to accept a certain amount of reimbursement from health insurance companies for their services; patients agree with their health insurance companies and employers to pay for part of the bill, to only use specific hospitals and physicians, and to accept any other guidelines and restrictions of the company

balance

the difference between debit and credit; it can be positive or negative

Diagnosis

the disease or condition that is named after a healthcare professional evaluates a patient's signs, symptoms and history

account

the financial record for a patient, business, or organization

epidural

the injection of an anesthetic agent into the epidural spaces between the vertebrae; also known as peridural or epidural block

ICD -10-CM

the new system for reporting diagnoses in the US

Compliance officer

the person in the workplace who is responsible for the provider's compliance with all HIPAA regulations

provider network

the physicians and health care facilities that have contracted with a health insurance company to provide services

Provider Network

the physicians and health care facilities that have contracted with health insurance company to provide services

Precertification

the process of obtaining approval from a health insurance company for an admission, a test, procedure, or medication

precertification

the process of obtaining approval from a health insurance company for an admission, a test, procedure, or medication; also called preauthorization

differential diagnosis

the process of weight the probability that other diseases are the cause of the problem. (a runny nose could be a cold or allergies)

Bookkeeping

the recording part of the accounting process

bookkeeping

the recording part of the accounting process

limits

the total amount that a health insurance company will pay for procedures and services; others involve the total amount the company will pay over a certain period of time

why the health insurance company may reject a claim

there may be discrepancies between the claim form and the information the health insurance company has regarding the patient's address, name or other identifying information; parts of the claim form may not be complete, there may be incorrect or incomplete ICD or CPT code, the patient may not have signed the form, or the writing may be illegible

if the patient and the guarantor are not the same

there will be a separate area on the insurance forms to fill out to indicate htis

intraservice

time begins with the administration of the sedation agent, ends when the personal contact by the physician ends

your responsibilities regarding billing

to create and mail statements and bills for money that patients owe to your clinic or office

check the financial and health insurance forms

to make sure they include the patient's name, Social Security number, address, and telephone number; confirm the patient's health insurance information is correct, including the compnay name, policy number, and group number

*Instrument to cut

tome

*incision

tomy

A wrong committed against another person or the person's property is a

tort

cephalic

toward the head

caudal

toward the lower part of body

medial

toward the middle or midline

lateral

toward the side

Endocrinology Physician

treat diseases and disorders of the glands, such as the thyroid and pancreas.

Pulmonologist

treat disorders and diseases of the lungs and respiratory system

Hematology

treat disorders of blood

Podiatric Physician

treat disorders of the foot and ankle

Orthopedist

treat patients who have acute or chronic bone or muscle disorders, as well as patients who have traumatic injuries to bones, muscles, or other supporting structures

Gynecologists

treat reproductive and sexual disorders in women

Exclusions

treatments or services that health insurance companies will not pay

exclusions

treatments or services that health insurance companies will not pay

*Instrument to crush

tripter

LPNs

typically complete a 1-2 year training program. usually work under a RN

bookkeeping cycle

typically lasts 1 month

iatrogenic illness

unfavorable response due to medical treatment

accounts payable

unmet financial obligations (unpaid bills that a clinic, physician's office, or hospital owes)

*urinary

urgent referral

urgent, but not life threatening situation occurs, requiring that the referral be taken care of quickly. approved in 24 hours.

*ur

urinary

UB-04 Form - aka: CMS-1450 form

used for institutional claims

Category III CPT

used for temporary coding for new technology and services

HCPCS Level II

used to report services, supplies, and procedures not represented in CPT.

Within the cardiovascular system, what is compared to the branches of a tree?

vascular families

The most formal of complimentary closing is:

very truly yours

*medical term for internal organs

viscera

*Good Samaritan Act

volunteer is not held liable for any civil damages

regular referral

when a physicians decides a patient needs to see a specialist. most common type of referral.

anesthesia services begin....

when the anesthesiologist begins preparing the patient until patient is turned over to post-anesthesia caregivers

when you can do the billling

when the patient checks in, when the patient checks out, or at a later date (according to policy and procedure)

*informed consent

written form that states their understanding

if patients ignore your calls and letters about overdue bills

you may be responsible for sending an overdue bill to a collection agency

Calculation of RBRVS

(physician work + malpractice expense + practice expense) x conversion factor = fee schedule

Cyanosis would turn your fingers blue and/or gray

If a doctor charges more than insurance will allow for a specific procedure he will have to write off the difference.

If a patient leaves an office and is nervous or worried about test results, to give them a sense of security verify that you have the correct contact information on file and that you know the preferred communication method.

If a patient misses an appointment because they are in the hospital be sure to alert the doctor

If you write a letter save it as a doc

If your out of pocket max is $1500 you would be responsible to pay that amount

Inactive patients are ones who have not been seen in 2 years

It is most effective to collect the amount due at the time of services

Medicaid is secondary to medicare

The CPT would be used to determine the code for a patient consulation

When a patient has an appointment in 45 days it is good to call them about a week before to remind them of it

Which modifier would you use if polyps were removed from both the left and the right sides of the nose?

-50

Know these med. terms: -lysis -ectomy -centesis -stomy

-destruction of red blood cells -surgical removal of -puncturing lung to drain -surgical opening

A patient who reports difficulty breathing

...

Creating retention schedule a pickup line

...

Doc ma should provide for pt to submit for reimbursment

...

Double booking

...

Open hours

...

Pt previously smokes on regular basis no longer smokes document on ph

...

Which is the best way for a medical assistant to address collection of copayment

...

According to the HIPAA privacy law, which of the following is a covered entity? A. The workers compensation carrier B. The consultant C. The patient D. The provider

.C. The patient

If your medicare deductible has been met for the year what percent in the patient's responsibility of future bills now?

ANESTHESIA CODES

00100-01999

Medicare covers physicals

1 per year

anesthesia providers may be:

1. anesthesiologists (MD) 2. certified registered nurse anesthetist (CRNA) 3. anesthesiologist's assistant (cannot work without oversight of anesthologist) 4. resident 5. student registered nurse anesthetist

to submit a claim

1. ensure the patient signs a form that permits you to release the information to the health insurance company (usually done when the patient first visits the office) 2. carefully and correctly fill out the claim form 3. each claim has to have the patient's and provider's basic identifying information, the International Classification of Diseases code for the diagnosis, the Current Procedural Technology code for the treatment provided, and the patient's basic health insurance information 4. retain a copy for the provider 5. submit the claim (usually electronically) 6. follow up with the health insurance company to make sure it received the claim and is processing it 7. document in the log when your follow up is complete

how to correctly fax or email PHI

1. identify the person who is asking for the PHI; find out his/her name, and the name, phone number, and address of his workplace 2. make sure he/she has a legitimate need for the PHI 3. if he/she does have a legitimate reason, ask for the fax number or email address to which you need to send the PHI 4. always confirm this information by repeating it back to him/her 5. after you fax/email the PHI, always call the recipient to make sure he/she received it

responsibilities in documenting the cash flow of your organization

1. post payments to the patients account 2. follow up with health insurance companies to make sure they receive submitted claims 3. determine the status of unpaid or late payments from health insurance companies and patients 4. prepare all checks and other forms of payments to vendors, suppliers, other physicians' offices or clinics, or any organization the clinic or office does business with for a signature 5. post the checks and payments to the vendors' and suppliers' accounts 6. make sure you always record these properly

if the patient cannot pay the entire bill when he/she receives the service, or if he/she needs to pay in cash or credit installments

1. prepare a payment agreement document and have the patient and the provider sign it 2. give both the patient and the provider a copy of this document; the document should state the total amount that is due, the payment due date, the number of payments, and the interest charged; it should also clearly document penalties for late payments or failure to pay

when collecting overdue bills

1. review the bill and confirm that all of the information is accurate 2. review the account and determine how old it is 3. follow the procedure the workplace established (some offices call the person or organization, and others send a letter)

steps in the process of bookkeeping

1. review the transactions (what your office receives and what it pays) for the specific time period 2. enter the transactions into the appropriate place (ex. patient's account) 3. post the transactions to the patient's, supplier's, or vendor's account 4. check the trial balance 5. if you find errors during the trial balance, make appropriate adjustments 6. enter adjustments that the worksheets generated into the appropriate account 7. prepare the income statement and balance sheet (after completing 1-6) 8. if the balance sheet is correct, the cycle is complete and you can start a new one

three ways in which HIPAA protects patient privacy

1. the only people who can have access to a patient's PHI are those people with a legitimate interest in the patient's case 2. before you share or transmit this protected information, you must make a reasonable effort to identify the recipient 3. you must always store a patient's PHI safely and securely

Per OSHA you have a written emergency plan if you have how many employees?

10 or more

SURGERY CODES

10021-69990

ADA

1990 - Americans with Disabilities Act - designed to ensure equal access to health care

HIPAA

1996 - Health Insurance Portability and Accountability Act - protects the privacy and security of patient information

When it is 4:00PM in New York City what time is it in Seattle, WA?

1:00PM

How long should authorization for an urgent referral take?

24 hr

Three-year-old Hannah is playing with a marble and sticks it in her nose. Her mother is unable to dislodge the marble so she takes Hannah to the physician's office. The physician removes the marble with hemostats. CPT Code: ____________________

30300

Douglas O'Mally, 31, has been having difficulty breathing and has had long-standing sinusitis. It is decided that Douglas will have a sinus endoscopy with a right anterior and posterior total ethmoidectomy with removal of polyps. CPT Code: ____________________

31255-RT

The physician uses an endoscope for surgical access to decompress the optic nerve in the posterior orbit. CPT Code: ____________________

31294

PREOPERATIVE DIAGNOSIS: Right pneumothorax POSTOPERATIVE DIAGNOSIS: Same PROCEDURE PERFORMED: Placement of anterior chest tube PROCEDURE: The patient was draped and prepped in the usual manner. The area was infiltrated with 1% lidocaine. A 1-cm incision was made in the second intercostal space about 7 cm to the right of the midline in the anterior chest and a 20-F chest tube was passed. Good tidal volume was confirmed. The chest tube was anchored using 1-0 silk. The area was dressed and the chest tube placed on suction. The patient tolerated the procedure well. Complications—none. CPT Code: ____________________

32551

The physician removes fluid from the chest cavity by puncturing through the space between the ribs. Using an aspirating needle attached to a syringe, the physician carefully passes the needle over the top of a rib, punctures through the chest tissues, and enters the pleural cavity. With the end of the needle in the chest cavity, the physician withdraws the fluid from the chest cavity by pulling back on the plunger of the syringe. CPT Code: ____________________

32554

Placement of a temporary pacemaker. The right subclavian area was prepped and draped in the usual fashion. Local anesthetic was infiltrated. The subclavian vein was entered via Seldinger technique with a Cook needle. A guidewire was passed to the right heart. A 6-French dilator sheath was placed. The dilator and wire were then removed. The sheath was sutured into place. A 5-French bipolar pacemaker wire was placed near the apex of the right ventricle. Temporary pacing was instituted. Threshold was less than 0.5 mV. Pacer settings were 60 per minute demand and 5 MA. Patient returned to her room in good condition. CPT Code: ____________________

33210

Selective catheterization of both renal arteries. The right femoral artery was entered by Seldinger technique, and a 6-French sheath was placed. No heparin was used. The patient had a BP of over 200 systolic. After placement of the 6-French sheath, a pigtail catheter was introduced and an aortogram was done in the AP projection using 20 cc of dye. Next a 5-French Cobra catheter was introduced, and both the left renal artery and the right renal artery were selectively opacified. The patient was sent to her room in good condition without complications after renal angiograms had been done, the sheath had been removed, and hemostasis had been secured. Results: Right renal artery—there is a single right renal artery with a minimal irregularity along the wall, but no evidence of significant fibromuscular dysplasia or stenosis is noted. The distal nephrogram appears unremarkable. Left renal artery—there are two renal arteries, the upper pole renal artery rising in the normal location and the lower pole renal artery considerably lower. Both these vessels appear relatively unremarkable with no stenosis or fibromuscular dysplasia seen either. CPT Code: (Surgery Code) ____________________

36252

If Mr. Jones insurance has $500 deductible and a $50 surgery copay, how much will his insurance pay on his bill of 4359.00

3809.00

The physician performs an extensive drainage of a lymph node abscess. CPT Code: ____________________

38305

Suprahyoid lymphadenectomy. CPT Code: ____________________

38700

Resection of a mediastinal tumor. CPT Code: ____________________

39220

The physician repairs a large laceration of the diaphragm that occurred during a car accident from the seat belt the patient was wearing through a transabdominal approach. CPT Code: ____________________

39501

What is gravida 3?

3rd Pregnancy

Plastic repair of the cleft lip/nasal deformity primary bilateral, one of two stages. CPT Code: ____________________

40702

I&D of a peritonsillar abscess. CPT Code: ___________________

42700

A diagnostic, transoral, flexible esophagoscopy was performed. During the procedure an esophageal polyp was found and removed by hot biopsy forceps. CPT Code: ____________________

43216

A direct ligation of esophageal varices. CPT Code: ____________________

43400

A morbidly obese patient's stomach is partitioned with a staple line on the lesser curvature. A short limb of small bowel 90 cm is divided and anastomosis is accomplished to the upper stomach pouch. CPT Code: ____________________

43846

The gallbladder is removed under laparoscopic guidance. CPT Code: ____________________

47562

Repair of an initial reduced inguinal hernia; with a hydrocelectomy in a patient who is 28 months of age. CPT Code: ___________________

49500

Category I CPT

5 digit codes and 2 digit modifiers ( changes/modifies the procedure)

RADIOLOGY CODES

70010-79999

Standard-size paperr and envelope for business correspondence is:

8 1/2 x 11; no. 10 envelope

PATHOLOGY AND LABORATORY CODES

80047-89398

The number of postoperative days usually assigned for the global period following implantation of a pacemaker is:

MEDICINE CODES

90281-99607

EVALUATION AND MANAGEMENT CODES

99201-99499

DEDUCTABLE

A FIXED DOLLAR AMOUNT THAT MUST BE PAID (YEARLY) BY THE INSURED BEFORE EXPENSES ARE COVERED BY THE INSURANCE

COINSURANCE

A FIXED PERCENTAGE OF COVERED CHARGES PAID BY THE INSURED PERSON AFTER A DEDUCTABLE HAS BEEN MET

ENCOUNTER FORM OR SUPER-BILL

A FORM THAT CAN BE USED AS THE ORIGINAL MEDICAL RECORD OF SERVICES PERFORMED FOR A PATIENT DURING AN ENCOUNTER OR OFFICE VISIT, AND CHARGES FOR THOSE SERVICES. THE FORM CAN ALSO BE USED AS A CHARGE SLIP, AS WELL AS AN INVOICE. IT CAN ALSO BE SUBMITTED WITH INSURANCE CLAIMS.

EXPLANATION OF BENEFITS - EOB

A FORM THAT EXPLAINS THE AMOUNT BILLED, AMOUNT ALLOWED BY INSURANCE CONTRACT, AMOUNT PAID BY INSURANCE CARRIER/COMPANY, AMOUNT OF SUSCRIBER'S/PATIENT'S LIABILITY, AND NOTATIONS OF ANY NON COVERED SERVICES WITH EXPLANATIONS.

ASSIGNMENT OF BENEFITS

A FORM THE PATIENT SIGNS "ASSIGNING" OR ALLOWING THEIR HEALTH INSURANCE BENEFITS TO BE PAID DIRECTLY TO THE PROVIDER

GEOGRAPHIC ADJUSTMENT FACTOR - GAF

A GEOGRAPHIC ADJUSTMENT FACTOR IS USED TO ADJUST EACH RELATIVE VALUE TO REFLECT A GEOGRAPHICAL AREA'S RELATIVE COSTS SUCH AS OFFICE RENTS.

TRICARE

A GOVERNMENT PROGRAM THAT PROVIDES HEALTH CARE BENEFITS FOR DEPENDENTS OF MILITARY PERSONNEL AND MILITARY RETIREES. THIS IS NOT AN INSURANCE PLAN BUT RATHER A HEALTH CARE BENEFIT FOR FAMILIES OF UNIFORMED PERSONNEL AND RETIREES FROM UNIFORMED SERVICES.

CLEARINGHOUSE

A GROUP THAT TAKES NONSTANDARD MEDICAL BILLING SOFTWARE FORMATS AND TRANSLATES THEM INTO THE STANDARD EDI (ELECTRONIC DATA INTERCHANGE) FORMAT

Privacy Rule

A HIPAA rule that establishes protections for the privacy of individual's health information.

FEE SCHEDULE

A LIST OF COMMON SERVICES AND PROCEDURES PERFORMED BY A PHYSICIAN AND THE CHARGES OF EACH

PREFERRED PROVIDER ORGANIZATION (PPO)

A MANAGED CARE PLAN THAT ESTABLISHES A NETWORK OF PROVIDERS TO PERFORM SERVICES FOR PLAN MEMBERS; REFERRALS NOT NEEDED TO SEE A SPECIALIST

ELECTIVE PROCEDURE

A MEDICAL PROCEDURE THAT IS NOT REQUIRED TO SUSTAIN LIFE, BUT IS REQUESTED FOR PAYMENT TO THE THIRD PARTY PAYER BY THE PATIENT OR PHYSICIAN. SOME PROCEDURES ARE PAID FOR BY THIRD PARTY PAYERS WHEREAS OTHERS ARE NOT - USUALLY NEED PREAUTHORIZATION

CONVERSION FACTOR - CF

A NATIONALLY UNIFORM CONVERSION FACTOR IS A DOLLAR AMOUNT USED TO MULTIPLY THE RELATIVE VALUES TO PRODUCE A PAYMENT AMOUNT. IT IS USED BY MEDICARE TO MAKE ADJUSTMENTS ACCORDING TO CHANGES IN THE COST OF LIVING.

CAPITATION

A PAYMENT STRUCTURE IN WHICH A HEALTH MAINTENENCE ORGANIZATION PREPAYS AN ANNUAL SET FEE PER PATIENT TO A PHYSICIAN

BIRTHDAY RULE

A RULE THAT STATES THE INSURANCE POLICY OF A POLICY HOLDER WHOSE BIRTHDAY COMES FIRST IN THE YEAR IS TO BE THE PRIMARY PAYER FOR ALL DEPENDENTS

The medical term for a decubitis ulcer, a pressure sore is

A bedsore

Daily Journal

A chronological record of bills received, bills paid, and payments and reimbursements received.

The notation c: Julia Jones, MD means:

A copy of the letter is sent to Dr.Jones

Supoena duces tecum

A court summons ordering the recipient to appear before the court and produce documents or other tangible evidence for the use at a hearing or trial

Day Sheet

A daily record of financial transactions and services rendered.

Invoice

A document that describes items purchased or services rendered and shows the amount due.

Encounter Form

A document used to collect data about elements of a patient visit that can become part of a patient record or be used for management purposes.

Subsidiary Journals

A document where transactions are summarized and later recorded in a general ledger.

Template

A document with a preset format that is used as a starting point so that it does not have e recreated each time.

Copayment

A fixed fee for a service or medication, usually collected at the time of service or purchase.

Coinsurance

A form of cost sharing the kicks in after the deductible has been met.

Matrix

A grid with time slots blocked out when physicians are unavailable or the office is closed.

Healthcare Common Procedure Coding System (HCPCS)

A group of codes and descriptors used to represent health care procedures, supplies, products, and services.

Reasonable standard care

A level of care that is safe, prudent, and within the norms of the medical community

Packing Slip

A list of items in a package.

Hyper-

A lot, high, excessive

Single-entry System

A method of bookkeeping that relies on a one-sided accounting entry to maintain financial information.

In Champus program, if the patient lives within 40 miles of a uniformed service hosptial and the necessary service are not avalible at the service hospital, for treatment in a civilian or physician office, it is necessary to obtain

A non availability statement

In thee POMR system the initial database includes:

A numbered list of present problems

Which of the following patient should a MAA address first? A. A person who is in hurry a hurry and is demanding to check out B. A patient who arrived at the clinic and is short of breath C. A person who is picking up reports for an emergency consultation D. A patient who is schedule for laboratory test

A patient who arrived at the clinic and is short of breath

Consent

A patient's permission

*Waiting Period

A period of time when you are not covered by the insurance

Hospitalist

A physician who provides direct care to patients admitted to a hospital

Explanation of Benefits (EOB)

A record of a patient's fees.

Statement

A request for payment.

Which of the following patients should receive priority scheduling? A. A school-aged child who has chicken pox B. An adult who has a fever of 101 C. An infant who has a rash D. A 55 year old adult who has a productive cough

A school-aged child who has chicken pox

Risk

A situation or condition that could result in injury to a patient or harm to an organization

Petty Cash Fund

A small amount of cash available for expenses such as postage, parking fees, small contributions, emergency supplies, and miscellaneous small items.

*Chief Complaint

A statement of the patient's symptoms

Which of the following circumstances would waive the need for a written release of medical records?

A subpoena

Double-entry bookkeeping

A system in which every entry to an account requires an opposite entry to a different account.

Provisional Diagnosis

A temporary or working diagnosis.

Emergent Care

A type of care delivered in response to an immediate health care need

*scopy

A visual examination

Which of the following is an example of a community resource? A. AARP B. CDC C. OSHA D. AA

ADD-ON CODE

CONSULTATION

ADVISE OR OPINION FROM ONE PHYSICIAN TO ANOTHER PHYSICIAN

What disease qualifies you for medicare?

AIDS

WHAT ARE THE TYPES OF REIMBURSEMENT THIRD PARTY PAYERS USE.

ALLOWED CHARGES CONTRACTED FEE SCHEDULE CAPITATION

CO-PAYMENT

AMOUNT A PATIENT HAS TO PAY AT TIME OF SERVICE DICTATED BY THE MANAGED CARE CONTRACT (HMO, PPO, OR POS)

REFERRAL

AN AUTHORIZATION FROM A MEDICAL PRACTICE FOR A PATIENT TO HAVE SPECIALIZED SERVICES PERFORMED BY ANOTHER PRACTICE (APPROVAL IS OFTEN REQUIRED FOR INSURANCE PURPOSES)

EXCLUSION

AN EXPENSE THAT IS NOT COVERED BY A PARTICULAR INSURANCE POLICY, SUCH AS EYE EXAMS OR DENTAL CARE

►◄

APPEARS AT THE BEGINNING AND END OF A SECTION OF NEW OR REVISED TEXT

ADMISSION

ATTENTION TO AN ACUTE ILLNESS OR INJURY THAT RESULTS IN HOSPITALIZATION

*The discontinuation of medical care without proper notice

Abandonment

If a provider goes out of town without ensuring coverage during her absence, a patient could initiate a lawsuit on the grounds of: A. Abuse B. Abandonment C. Negligence D. Malpractice

Abandonment

The withdrawal of a physician from the care of a patient without reasonable notice of such discharge from the case by the patient is

Abandonment

The cavity between the diaphragm and the floor of the pelvis in which the stomach, intestines, etc are located is clled

Abdomen

The medical term for moving a body part away from the body is

Abduction

The expulsion of a nonviable fetus prior to term either involuntary or induced is called

Abortion

The word element super means

Above

Epi-

Above, Upon

Open punctuation is characterized by:

Absence of punctuation after the salutation and a comma after the complimentary close.

An unexpected event which may cause injury is called

Accident

A system of recording, classifying and summarizing financial transactions is called

Accounting

Which of the following is the most important component when transcribing documents and correspondents? A. Speed in document turnaround time B. Work knowledge of medical terminology C. Correct use of grammar D. Accuracy of the document

Accuracy of the document

The tendon that connects the muscle at the back of the calf to the bone of the heel is called

Achilles tendon

a chemical imbalance in the blood marked by an excess of acid, sometimes affecting diabetics a possibly leading to a diabetic coma is called

Acidosis

A common eruptive skin disorder resulting from the clogging or inflammation of the sebaceous glands is called

Acne

A disorder of the pituitary gland which is characterized by an enlarged head hands or feet is called

Acromegaly

A fear of height is called

Acrophobia

To address collection of copayment End of day MA should

Activate security system

An oriental art of medicine in which needled are inserted into the skin to relieve or treat disease is called

Acupuncture

A temporary loss of consciousness caused by the failure of the heart to miss a beat is called

Adams-Strokes disease

Modifiers

Added information or changed description of procedures and services and are a part of valid CPT or HCPCS codes

Modifiers

Added information or changed description of procedures and services, and are a part of valid CPT or HCPCS codes.

The compulsive use of a drug or other substance for other than a medical reason is called

Addiction

Which of the following is new to ICD-10 (compared to ICD-9)

Additional letters and digits

The medical term for moving a body part towards the body is

Adduction

An enlarged lymphoid growth behind the pharynx is called

Adenoid

A "T and A" operation is called

Adenotonsillectomy

One who acts for the insured or the carrier in a claim is called

Adjuster

ASCA

Administrative Simplification Compliance Act - requires claims to Medicare be transmitted electronically

An adrenal hormone that acts to stimulate the heart, dilate the blood vessels, and relax the bronchial smooth muscles is called

Adrenaline and Epinephrine

ABN

Advance Beneficiary Notice of Noncoverage - form provided to a patient if a provider believes that a service may be declined by Medicare

A patient who has Medicare would like to have a non-covered service. which of the following forms should the patient sign before seeing the provider? A. Consent form B. Assignment of benefits C. Advanced beneficiary notice D. Medicare summary notice

Advanced beneficiary notice

Nurse Practitioner (NP)

Advanced practiced nurses, with a master's degree or doctorate and specialized area of practice. They can prescribe and treat as well as independently bill insurance companies. In some providers' offices, the NP will examine and treat patients who have minor, uncomplicated problems.

Elderly pt and daughter visit the office .. they ask question about medication

Advise patient and daughter to speak with the doctor

ACA

Affordable Care Act - enacted to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance coverage, and reduce the costs of healthcare

The word element post means

After

*anti

Against

The word element pneumo means

Air,Lungs

*Pertaining to

The presence of protein in the urine is called

Albuminuria

*pain

Algia

Both paper and electronic medical records

All of the above

Which group of patients should be escorted to the examination room and given instructions on what they are to do?

All patients

An annual recurring inflammation of the mucous membranes of the nose and eyes which is normally caused by pollen is called

Allergen

A violent shock reaction often accompanies by a rash resulting from an oversensitivity reaction to a foreign substance such as medication or an insect bite is called

Allergic shock and anaphylactic shock

Right to know LAw

Allows employees access to information regarding workplace safety

Physicians

Also called doctors, diagnose illnesses and injuries, prescribe treatments, and preform procedures. They are legally and professionally responsible for determining why a patient is suffering and how to treat the condition.

Air sacs that are situated in the lungs are called

Alveoli

A patient that is able to walk is considered

Ambulatory

If something was not originally documented in a chart you should:

Amend the chart

AMA

American Medical Association - professional organization for the nation's medical providers - it is concerned with ensuring high-level treatment at affordable prices

ASL

American Sign Language

ASA

American Society of Anesthesiologists

law created in 1990 designed to ensure equal access to health care

Americans with Disabilities Act (ADA)

What is a deductible?

Amount of money that the insured must pay before an insurance company will pay a claim

To remove surgically by cutting as a gangrenous limb is called

Amputate

A numeric filing system requires the use of:

An alphabetic cross-reference

When scheduling a patient for a routine visit the CMAA should provide the patient with

An appointment reminder card

Electronic Health Record (EHR)

An electronic health record of health-related information about a patient that conforms to nationally recognized interoperability standards that can be created, managed, and reviewed by authorized providers and staff from more than one health care organization.

Electronic Medical Record (EMR)

An electronic record of health information that is created, added to, managed, and reviewed by authorized providers and staff within a single health care organization.

Electronic Medical Record (EMR)

An electronic record of health information that is created, added to, managed, and reviewed by authorized providers and staff within a single healthcare organization.

Electronic health record (EHR)

An electronic record of health-related information about a pt. that conforms to nationally standards and can be reviewed and managed by authorized providers and staff from more than one health care organization.

Blood borne pathogen standards

An osha regulation must be reviewed yearly to ensure compliance

In an alphabetical file, which is filed first?

Andrew Stephen

A deficiency in the amount or quality of red blood corpuscles or of hemoglobin in the blood is called

Anemia

A physician that specializes in the study and administration of anesthetics is called

Anesthesiologist

A localized dilation of the wall of an artery forming a pulsating sac and usually accompanied with pain is called

Aneurysm

When reviewing incoming mail, the practice of underlining significant words and phrases during sorting is called: A. Annotating B. Releasing C. Indexing D. Conditioning

Annotating

If you are reviewing mail what is it called when you underline important words?

Annoting

The medical term for loss of appetite

Anorexia

An emotional disturbance characterized by aversion to food and resulting emaciation is called

Anorexia nervosa

Which of the following calls require immediate transfer to the physician?

Another physician

*Before/in front of

Ante

*front surface of the body starting with an A

*front surface of the body that starts with an A

*Against

Anti

Anything that neutralizes or counteracts the effects of a poison is called

Antidote

Neurosis characterized chiefly by anxiety unrelated to any apparent cause is called

Anxiety reaction

Which of the following is a characteristic of a receptionist might make an impression on a patient?

Appearance

A surgical removal of the appendix is called

Appendectomy

*impartial third party for the hearing and determination of a dispute

Arbitration

*Systems

Are groups of organs working together to perform complex functions

Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS)

Are used to report provider services for the purpose of reimbursement.

An x-ray picture of an artery is called

Arteriogram

A thickening or hardening of the walls of artery with impariment of of blood circulation is called

Arteriosclerosis

Inflammation of a joint characterized by pain swelling and tenderness is called

Arthritis

When creating area pediatrician office

Artificial aesthetics- Fake plants.

A withdraw by suction is called to

Aspirate

An unlawful threat or attempt to do bodily injury to another is

Assault

The properties owned by a business are called

Assets

Terminal Numbering System

Assigning consecutive numbers to patients while separating the digits in the number into groups of twos or threes.

An agreement by which a patient assigns to another party the right to receive payment from a third party for the serivce the patient has revceived is called

Assignment

*Patient requests that benefit payments be made directly to a physician

Assignment of Benefits

When the physician signs a contract with the insurance company stating he will accept the payment allowed as payment in full, it is called

Assignment of Benefits

The process by which digestive food is made an integral part of solid or fluids of an organis is called

Assimilation

Consent to treatment based on a full understanding of all possible risks unpreventable results of that treatment is called

Assumption of risk

Distorted vision caused by an uneven curvature of the cornea is called

Astigmatism

Patients who are always late or who habitually cancel appointments should be scheduled:

At the end of the day

Ringworm of the foot caused by a parasitic fungus is called

Athlete's foot

The medical term for a derease in size or a wasting is

Atrophy

The wasting or withering of the body or any other part as from disease or lack of use is called

Atrophy

One who specializes in the treatment of those with hearing problems is called an

Audiologist

Which of the following should a MAA is to create a report on access to patient accounts? A. Computerized order entry B. CMS-1500 claim form C. UB-92 claim form D. Audit trail

Audit trail

A temporary sensory perception that occurs just before the onset of an epileptic convulsing or migraine headache is called

Aura

Mental disorder of children marked by lack of response to external activities is called

Autism

The postmortem examination of a person to determine the real cause of death is called a

Autopsy

BLUE CROSS/BLUE SHIELD - BCBS

BLUE CROSS BLUE SHIELD IS A NATION WIDE FERERATION OF NONPROFIT AND FOR PROFIT SERVICE ORGANIZATIONS THAT PROVIDE PREPAID HEALTH CARE SERVICES TO SUBSCRIBERS; BLUE CROSS COVERS MEDICAL BILLS (DOCTOR;S VISITS) AND BLUE SHIELD COVERS HOSPITALIZATION

*Dorsal

Back side of the body

This procedure protects against the loss of data

Backing up

*unlawful use of force or violence

Battery

A deliberate physical attack upon a person is called

Battery

A provider did not obtain an informed consent patient before surgery. the provider can be charged with which of the following ? A. Battery B. Assault C. Negligence D. Libel

Battery

If you don't obtain content to perform surgery what can the doctor be charged with?

Battery

*Pre

Before

Ante-

Before

Pre-

Before

Which of the following is an important time to print encounter forms for the days schedule patients? A. After patents have canceled their appointments B. Before the beginning of the work day C. When patients arrive for their appointments D. The beginning of the wee

Before the beginning of the work day

Facial paralysis resulting from a lesion of the facial nerve is called

Bell's Palsy

When thee word confidential is to be typed on the envelope. it should be placed:

Below the address

Hypo-

Below, Under, Less than normal

A sum of money provided in a insurance policy, payable for covered services is called

Benefits

According to aca

Bill has 12 months from date of aervice to be submitt

The branch of study of moral issues, questions, and problems arising in the practice of medicine and in biomedical research is called

Bioethics

Birthday rule

Birthday month that occurs first

The smallest piece of information that the computer can process is a(n):

Bit

A small rounded sac, especially on the skin containing fluid matter, oftern resulting from injury friction or scalding is called

Blister

What do firewalls do to protect PHI?

Block access to unauthorized parties

If the doctor is going to be away what should you do to his schedule for those days?

Block off

The suffix EMIA means

Blood

The word element hema hemo means

Blood

What does a hematologist study?

Blood

*Emia

Blood condition

*transportation/blood cells

Blood/Lymphatic

BC/BS

Blue Cross/Blue Shield - the 1st prepaid plan in the US that offers health insurance

Is BCBS an acronym for a health insurance plan?

Bluecross Blueshield

Oste/o

Bone

Cluster or Categorization Booking

Booking a number of patients who have specific needs together at the same time of day.

A poisoning caused by eating spoiled or improperly prepared or canned food and characterised acute gastrointestinal and nervous disorders is called

Botulism

The breaking of a law, promise, or duty is called

Breach

Failure to achieve an agreed upon result, even when the highest degree of skill has been used is called

Breach of contract

Violation or admission of a legal or moral duty is called

Breach of duty

A birth when the baby is positioned to present the buttocks first instead of the head first is called

Breach presentation

Mast/o

Breast

The word element mast means

Breast

Inflammation of the bronchial tubes characterized by coughing chest pain and fever is called

Bronchitis

A disorder involving overeating followed by self-induced vomiting is called

Bulimia

*mailing large volumes of information which is presorted by zip code

Bulk Mailing

Inflammation of any of the fluid filled sacs within the body that tend to lessen friction between movable parts is called

Bursitis

Inflammation of the knee:

Bursitis

According to local, federal and state regulations, a MAA must make sure each patient: A. Receive a copy of OSHA requirement B. Has a referral from a primary care physicians C. Receives a copy of the notice of privacy practice D. Has an IRS from form for taxes

C. Receives a copy of the notice of privacy practice

Centers for Disease Control and Prevention-Abbreviation

CDC

CMMS

CENTERS FOR MEDICARE AND MEDICADE SERVICES IS A CONGRESSIONAL AGENCY DESIGNED TO HANDLE MEDICARE AND MEDICAID INSURANCE CLAIMS. IT WAS FORMERLY KNOWN AS THE HEALTH CARE FINANCING ADMINISTRATION (HCFA)

WHAT IS TRICARE FORMERLY KNOWN AS

CHAMPUS

A government health insurance for spouses and dependant children of veterans who are totally disabled or who have died in service-related activities is called

CHAMPVA

CHAMPUS

CIVILIAN HEALTH AND MEDICAL PROGRAM FOR UNIFORMED SERVICES.

Which agency oversees medicaid and medicare?

CMS

Who determines the fee schedule?

CMS

The universal claim form developed by HCFA is:

CMS-1500

CPT CODES

COMMON PROCEDURAL TERMINOLOGY CODES - A SET OF NUMBERS/LETTERS THAT CORRESPOND TO COMMON PROCEDURE - THIS CODE IS ON THE ENCOUNTER FORM AND IS TRANSPOSED TO THE INSURANCE CLAIM FORM

Which of the following is included in a provider's free schedule? A. CPT codes B. Provider's name C. National provider identifier number D. ICD-9-CM

CPT codes

A listing of medical procedures and treatments, known as physicians Current Procedural Terminology is called

CPT-4 Codes

concurrent modifiers

CRNAs may administer anesthsia to patients under direction of licensed physician, or work independently; an anesthesiologist may medically direct up to 4 cases at the same time (concurrently). if more than 4 cases, it is referred to as medical supervision. must be present at the induction and emergence from anesthesia, for all key portions of the procedure and available in case of emergency. the CRNA would be with the patient the entire time

A patient contacts a provider's medical office complaining of chest pains moderate shortness of breath. The MAA should instruct to the patient to do the which of the following? A. Take an aspirin immediately B. Call 911 C. Drive to emergency department D. Come to the office immediately

Call 911

*Carcin

Cancer

Oncologist

Cancer Dr

When the health care provider is paid a fixed amount for each person treated regardless of service provided, is called

Capitation

*Cancer

Carcin

A stopping of the heartbeat is called

Cardiac arrest

A physician specializing in the diagnosis and treatment of heart disease is called

Cardiologist

MA in a multi specialty practice is scheduling an appointment for a patient who has an arrhythmia

Cardiologist

An organization that offers insurance against losses in exchange for a premium is called

Carrier

Chondr/o

Cartilage

Health insurance that provides protection against the high cost of treating severe or lengthy illnesses or disabilities is called

Catastrophic

-cyte

Cell

The medical term for the basic unit of body structure is

Cell

CMS

Center for Medicare/Medicaid Services - an organization that oversees Medicare and Medicaid

CDC

Centers for Disease Control and Prevention - concerned with the health and safety of people worldwide

If you are send a letter telling a patient they are being discharged, you would use what type of mail?

Certified

*mailing gives the sender the option to receive proof of delivery

Certified Mail

A civilian health and medical program of the uniform services is called

Champus

Which of the following is the first step a cmaa should complete when creating a tickler system to mail reminder letters? A. Check patients account balance B. Verify patients insurance information C. Verify names and address of patient D. Check future appointments

Check future appointments

What requires a MSDS?

Chemical solution

Thorac/o

Chest

*A statement of the patient's symptoms

Chief Complaint

Chief complaint. Reason for visit.

Cheddar

Chief diagnosis

Occuring gradualy over an extended period of time as a disease is referred to as

Chronic

Pericardiocentesis is part of which body system?

Circulatory

A statute that enforces private right and liabilities, as differentiated from criminal law is called

Civil Law

A request for payment under an unsurance contractor bond is called a(n)

Claim

Included in an explanation of benefits

Claims adjustment

Providers office receives RA rejected claim

Claims appeal

Transference of words into numbers for use of computers in claim processing is called

Coding

A requirement under a health care policy dictates that the insured be responsible for a percentage of covered services. This is called

Coinsurance

percentage is

Coinsurance

The inflammation of the colon is called

Colitis

Doctors must sign letters that are going to

Colleagues

Colon/o

Colon

Insurance, greater coverage of disease or accident, and greater indemnity payment in comparison with a limited clause is called

Comprehensive

-ia

Condition

the word element osis means

Condition of

This type of call allows more than one person in more than one place to talk simultaneously

Conference call

CHF stands for

Congestive heart failure

Permission granted by a person voluntarily and in his right mind is

Consent

An agreement between two or more parties for the doing or not doing of some definite thing is

Contract

Which of the following is proper protocol when following up on suspended, nonpayment and payment denials of claims third party payers? A. Notify the patient of the pay status and advise her to contact the third party payer B. Notify the collection agency of the patient's balance C. Contract the insurance provider to confirm claim status D. Post contractual adjustments to patient's account

Contract the insurance provider to confirm claim status

Which of the following is proper protocol when following up on suspended, nonpayment and payment denials of claims third party payers? A. Notify the patient of the pay status and advise her to contact the third party payer B. Post contractual adjustments to patient's account C. Notify the collection agency of the patient's balance D. Contract the insurance provider to confirm claim status

Contract the insurance provider to confirm claim status

The medical term for the abnormal shortening of a muscle is

Contracture

Failure to act prudently and reasonably, or doing that which a reasonable person would not do under the same or similar circumstances is called

Contributory Negligence

To prevent the insured from receiving a duplicate payment for losses under more than one insurance policy is called

Coordination of benefits

A type of insurance whereby the insured pays a specific amount per unit of service and the insurer pays the rest of the cost is called

Copayment

thee portion of the fee that a patent with insurance must pay at the time of treatment is called the:

Copaymeny

Subpoena

Court order of pt records

Which of the following is the first in maintaining an inventory of materials needed? A. Establish a schedule for taking inventory B. Create a supply list C. Establish an inventory management policy D. Create a vendor list

Create a supply list

Microsoft Access

Creating a database

An act that violates criminal law is called

Crime

A freezing of the skin is called

Cryosurgery

The word element cise means

Cut

Before a patient has outpatient surgery the MAA should: A. Pre-certify the procedure with the patient's insurance company B. Ensure the patient has paid for the procedure C. Ensure the patient has followed preoperative instruction D. Review the informed consent from with the patient

D. Review the informed consent from with the patient

If 2 people have the same name confirm the correct patient by checking their?

D.O.B.

Which of the following is necessary for a prescribe and dispense controlled substances? A. UPIN number B. DEA number C. Preauthorization number D. License number

DEA number

In double-entry bookkeeping the original entry is put onto the:

Daily log

Which of the following is the proper procedure for a MAA when modifying a patient's record? A. Obtain insurance authorization B. Date and initial charge C. Review and file the charge claim D. Obtain the physician's signature

Date and initial charge

If you make a change in a chart what do you do?

Date and initial it

WhenDocumenting prescription refill

Date and initial refill in record

*Tickler File

Date labeled used as a follow up method should be checked daily

Which of the following demographic information is included in a medical record?

Date of birth

Which of the following is demographic information included in a medical record?

Date of birth

Which is correct for an inside address

David Roberts, M.d.

Which of the following is appropriate when addressing a business letter? A. Dear Robert Jones, MD B. Dear Doctor Jones C. Dear Doctor Robert Jones D. Dear Dr. Jones, MD

Dear Dr. Jones, MD

An amount the insured must pay before policy benefits begin is called

Deductible

Injuring the name and reputation of another by making false statements to a third person is

Defamation

A person sued is clled the

Defendant

Respiratory Therapist

Deliver direct patient care and treatments that provide support for a patient's lungs and respiratory status. They set up oxygen equipment, administer medications, such as a nebulizer treatments to patients who have asthma, and provide other services as needed. Typically possess a 2 or 4 year college degree.

What is found on the patient encounter form and the CMS-1500 claim form?

Demographic and accounting info, professional services rended, CPT and ICD-9 codes, professional fees, and return appointment information

A patient who was referred to the office sends a signed letter requesting an amendment to part of his medical record. which of the following actions should the provider take? A. Follow the recommendation of the insurance company B. Modify the record as the patient requested C. Charge the patient an appropriate change fee D. Deny the request because the provider did not create the record

Deny the request because the provider did not create the record

The medical term for a preparation that masks and controls body odor is

Deodorant

HHS

Department of Health and Human Services - the main US agency charged with protecting the health of all Americans

A chemical product capable of removing or loosening hair is called

Depilatory

When money is placed in an account which of the following documents is prepared

Deposit slip

Testimony of a witness under oath and written down before trial for possible use when the case comes to trial is

Deposition

*Skin

Derm

A physician specializing in the diagnosis and treatment of disorders of the skin is called

Dermatologist

*Through/complete

Dia

All of the following would require a CPT code except:

Diarrhea

A provider is requesting a referral for a patient to see a dermatologist. Which of the following is unnecessary when completing the referral? A. Differential diagnosis B. Name of the referring provider C. Insurance information D. Requested procedure name of the referring provider

CMAA acronym list, CMAA #2, CMAA MOCK EXAM(1), CMAA2, CMAA # 2-Tech Center, CMAA Study Guide #2, MOAST CMAA Ch 7 Day 1 - Overview & Using Med Term & MT Ch 2, Medical Billing and Coding Part II-Cumulative Test - Chapters 16, 17, 18 and 19, Medical Ass...

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