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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. Pre-determined set of benefits covered under one set annual fee.






2. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.






3. This is a set of information the physician gathers from the patient regarding the following:






4. Is defined as a doctor of medicine or osteopathy - dental medicine - dental surgery - podiatric medicine - optometry - or chiropractic medicine legally authorized to practice by the state in which he/she performs.






5. Are conditions - situations - and services not covered by the insurance carrier.






6. This modifier is used when: more than one procedure is performed during the same surgical episode; one code does not describe all of the procedures performed; and the secondary procedure is not minor or incidental to the major procedure. The followin






7. provides a five-digit code which gives the highest specificity of description to a condition. Use of it is mandatory if it is available. A code not reported to the full number of digits required is invalid. e.g. 240.01 Toxic diffuse goiter with thyr






8. Forms the anterior part of the skull and the forehead






9. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.






10. open sore on the skin or mucous






11. Is a cost-sharing requirement for the insured to pay at the time of service. This amount is usually a specific dollar amount (e.g.. $15 - $20 - $25)






12. Make up part of the interior of the nose.






13. Upper jaw bone






14. The poisoning was self-inflicted.






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






16. This modifier is used when: more than one procedure is performed during the same surgical episode; one code does not describe all of the procedures performed; and the secondary procedure is not minor or incidental to the major procedure. The followin






17. Is defined by Medicare as 'the determination that a service or procedure rendered is reasonable and necessary for the diagnosis or treatment of an illness or injury.'






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






19. The physician must obtain this number in order to practice within a state.






20. are composed of a group of three-digit categories representing a group of conditions or related conditions; they are divided into categories. e.g. . - Disorders of Thyroid Gland (240 - 246).






21. Also known as Federal tax identification number. This is issued by the Internal Revenue Service






22. Make up part of the interior of the nose.






23.






24. forms the roof of the nasal cavity.






25. solid - round or oval elevated lesion more than 1 cm in diameter






26. Cheekbone






27. includes the shoulder girdle which is made up of the scapula - clavicle and upper extremities. The scapula - or shoulder blades are flat bones that help support the arms. The clavicle - or collarbone - is curved horizontal bones that attach to the u






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






29. Is a working diagnosis which is not yet established.






30. The lower anterior part of the bone






31. paired bones at the corner of each eye that cradle the tear ducts.






32. Unlike the RBRVS - the RVP has no geographic adjustment factor or individual RVU component to calculate. However - for each category of procedures - a separate conversion factor must be developed....






33. The bones are connected to one another by fibrous bands of tissue . Muscles are attached to the bone by tendons. The fibrous covering of the muscles is called the fascia






34. Retention of medical records is governed by state and local laws and may vary from state-to-state. Most physicians are required to retain records indefinitely; deceased patient records should be kept for at least five (5) years.






35. This is defined as incidents or practices - not usually considered fraudulent - that are inconsistent with the accepted medical business or fiscal practices in the industry. Examples of abuse are submitting a claim for a service or procedure performe






36. 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.






37. Families - pregnant women - and children ;Aid to Families with Dependent Children (AFDC)-related groups ;Non-AFDC pregnant women and children;Aged and disabled persons ;Supplemental Security Income (SSI)-related groups ;Qualified Medicare Beneficiari






38. major skin pigment






39. An insurance plan issued to an individual. Premium rates are usually higher than group rates and service availability is lessened with this type of coverage.






40. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.






41. Developed by the CMS to promote national correct coding methodologies and to control improper coding that leads to inappropriate payment of Part B health insurance claims.






42. Noninvasive - non-spreading - nonmalignant






43. Is one who has received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years....






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






45. Groove or crack like sore






46. Represents a change in the code description since the last edition. The change may be minor or significant and it could be an addition - deletion or revision.






47. 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'.






48. contains errors or omissions. Usually - these claims do not pass front-end edits. They are either processed manually for resolving problems - or rejected for payment.






49. Used for procedures that is always performed during the same operative session as another surgery in addition to the primary service/procedure and is never performed separately.






50. Represent services and procedures widely used by many health care professionals in clinical practice in multiple locations and have been approved by the FDA.