Quizlet medical billing and coding certification exam

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Terms in this set (42)

UB04 form is used for

Hospice, Ambulatory Surgery Centers, Home Health Care

patient confidentiality

treating patient's medical information as private and not for publication

signing an Acknowledgement of Notice of Privacy Practice is accepting what

HIPAA

form to authorize sharing of medical information

medical release form

standard form used for medical billing

CMS-1500

must appear on CMS 1500 form prior to submission

birth date in 8 digit format, all caps

encounter form

financial record source document to record treated diagnosis and services rendered to the patient during the current encounter. also called the superbill

where non allowed charges are recorded

adjustment column

10 digit numeric identifier required in box 33A of CMS 1500

National Provider Identifier (NPI)

CLIA - Clinical Laboratory Improvement Act

quality standards for lab tests

most common reason for claim rejection

incorrect or incomplete information

PICA pitch 10

written CMS 1500 form

PICA pitch 12

electronic CMS 1500 form

delinquent claim

not paid within a certain amount of time

implied contract

patient scheduling an appointment with a new provider

bullet/solid circle

symbol used to indicate a new CPT code

plus sign (+)

add on CPT code symbol

triangle

new/revised code in HCPCS level 1

multiple, varying wound sizes

add the sizes together

dependents of military personnel

required to have military ID for TriCare insurance

used as first-listed diagnosis to indicate family history

V-Code

diagnostic category code

three digit code that covers a single disease or relative condition

standard medical code sets

ICD-9-CM, HCPCS, CPT, HCPCS Level II

insurance claim register

diary or ledger of submitted claims

appeal

explains why claim should be re-considered for payment

offer Medigap

private commercial insurance companies

hemodialysis

found in medicine secion of CPT manual

payer of last resort

Medicaid

Medicare Administrative Contractor (MAC)

Third party that contracts with CMS (Centers for Medicare and Madicaid Services) to process claims and perform integrity tasks - accepts electronic claims

pending

submitted for review not yet paid

co-payment

cost sharing requirement for the insured to pay at the time of service

steps for coding 1st, 2nd, and 3rd degree burns

depth, extent, agent (e-code). 3rd degree first

privacy officer

protects patient health information

ICD-9 principle

code signs and symptoms in absence of established diagnosis

classifications of neoplasms in table of neoplasms

malignant, benighn, uncertain, un-specified, specific, in-situ (6)

form needed for medicare patient when services for diagnostic tests are not covered

ABN (Advanced Beneficiary Notice)

valid ICD-9 principle

code to the full number of digits required for that code or it is invalid

claim control number

claim ID or DCN (document control number) assigned to each claim

time reporting

guideline for anesthesiology, 24G on CMS 1500

developed and updates the CPT manual

AMA (American Medical Association)

patient ledger account

permanent record of all financial transactions between the practice and the patient

bull's eye

CPT symbol for conscious moderate sedation

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ADVANCED MATH

A rope is cut into three pieces P, Q, and R. The lengths of the pieces are in the ratio 3:5:7. If the rope is 33 feet 9 inches long, find the length of P, Q, and R.

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ADVANCED MATH

The following arguments are inductive. Determine whether each is strong or weak, and note the relationship between your answer and the truth or falsity of the premise(s) and conclusion. Then determine whether each argument is cogent or uncogent. The ebb and flow of the tides has been occurring every day for millions of years. But nothing lasts forever. Therefore, probably the motion of the tides will die out within a few years.

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ADVANCED MATH

Show that the dictionary order topology on the set $\mathbb{R} \times \mathbb{R}$ is the same as the product topology $\mathbb{R}_{d} \times \mathbb{R}$, where $\mathbb{R}_{d}$ denote $\mathbb{R}$ in the discrete topology. Compare this topology with the standard topology on $\mathbb{R}^{2}$.

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ADVANCED MATH

Construct a diffeomorphism between the ellipsoid $$ \frac{x^{2}}{a^{2}}+\frac{y^{2}}{b^{2}}+\frac{z^{2}}{c^{2}}=1 $$ and the sphere $x^{2}+y^{2}+z^{2}=1$.

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