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Medical Billing And Coding Vocab

Instructions:
  • Answer 50 questions in 15 minutes.
  • If you are not ready to take this test, you can study here.
  • Match each statement with the correct term.
  • Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. 'Errors and omissions insurance' is protection against loss of monies caused by failure through error or unintentional omission on the part of the individual or service submitting the insurance claim. Some physicians' contract with a billing service






2. Is the lateral lower arm bone (in line with the thumb).






3. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called






4. Is a percentage of the cost of covered services that a policyholder or a secondary insurance pays. A common payment percentage for coinsurance is 80/20 which indicates that 20% is the coinsurance for which the beneficiary or secondary insurance is re






5. are small with irregular shapes. They are found in the wrist and ankle.






6. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.






7. make up part of the roof of the mouth






8. Is an entity that receives transmissions of claims from physicians' offices - separates the claims by carriers and performs software edits on each claim to check for errors. Once this process is complete - the claim is then sent to the proper insuran






9. This modifier is used when the same procedure is performed on a mirror-image part of the body..






10. is a federal program administered by state governments to provide medical assistance to the needy. Each state sets its own guidelines for eligibility and services - therefore benefits and coverage may vary widely from state to state.






11. represents Exemption from the use of modifier -51






12. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.






13. All patients have a right to privacy and all information should remain privileged. Discuss patient information only with the patient's physician or office personnel that need certain information to do their job. Obtain a signed consent form to releas






14. This is the traditional method used by providers for submission of charges to insurance companies. The most commonly used form is the CMS-1500. Few plans still accept the physician's encounter form or superbill and Medicare will only accept claims on






15. Consists of the skull - rib cage - and spine






16. The main term in the index may by followed by terms within parenthesis.






17. Benign growth extending from the surface of the mucous membrane






18. Discolored - flat lesion (freckles - tattoo marks)






19. The lower anterior part of the bone






20. The break of the distal end of the radius at the epiphysis often occurs when the patient has attempted to break his or her fall.






21. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.






22. Number assigned by the insurance company to a physician who renders services to patients.






23. A fat cell






24. Is a group of two or more physicians and non-physician practitioners legally organized in a partnership - professional corporation - foundation - not-for-profit corporation - faculty practice plan - or similar association.






25. Knowingly and intentionally deceiving or misrepresenting information that may result in unauthorized benefits is known as fraud.. Common forms of fraud are billing for services not furnished - unbundling - and misrepresenting diagnosis to justify pay






26. Small collection of clear fluid;blister






27. Groove or crack like sore






28. This is not specified as benign or malignant in the diagnosis or medical record.






29. Contain the full description of the procedure for the code indented codes: these are codes listed under associated stand-alone codes. To complete the description for indented codes - one must refer to the portion of the stand alone code description b






30. major skin pigment






31. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.






32. Are small - rounded bones that resemble a sesame seed. They are found near joints and increase the efficiency of muscles near a joint. An example of sesamoid bone is the knee cap.






33. The CPT manual is composed of eight sections. Each section begins with guidelines that provide specific coding rules for that section. Guidelines at the beginning of the section are applicable to all codes in the section - while notes that pertain t






34. Are the main division in the ICD-9-CM; they are divided into sections. e.g.. - 3. Endocrine - Nutritional and Metabolic Diseases - and Immunity Disorders (240-279).






35. Are codes formulated thru the joint efforts of the CMS - the Health Insurance Association of America - and the Blue Cross and Blue Shield Association. Level II contains five position alpha-numeric codes for physician and non-physician services not fo






36. This modifier is used to report a procedure or service that has more than one Modifier but the third-party payer does not allow the addition of multiple modifiers to the code. Modifier -99 is attached to the procedure code and the multiple Modifiers






37. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.






38. requires investigation and needs further clarification.






39. Is one who has no contract with the health insurance plan.






40. Is a requirement for some health insurance plans to obtain permission for a service or procedure before it is done. It indicates that a specific procedure or service is deemed 'medically necessary'.






41. Is the upper arm bone.






42. To report a circumstance in which the physician returns to the operating room to address a complication stemming from the initial procedure - modifier -78 is attached to the subsequent procedure code.






43. A fat cell






44. These parenthetic terms are called because their presence or absence does not have an effect on the selection of the code listed for the main term.






45. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.






46. The epidermis - the dermis - and the subcutaneous layer. The epidermis is a thin - cellular membrane layer that contains keratin. The dermis is a dense - fibrous - connective tissue that contains collagen. The subcutaneous layer is a thicker and fatt






47. - To pay for medical services and items that Medicare does not cover and Medicare's coinsurance and deductibles - beneficiaries may purchase a supplemental insurance. Medigap is a private insurance designed to help pay for those amounts that are typ






48. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.






49. Further classified as to primary - secondary - or carcinoma in situ.






50. found in the Index under the main term 'Hypertension' - and it contains a list of conditions that are due to or associated with hypertension. The table classifies the conditions as: