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Medical Billing And Coding Vocab

Instructions:
  • Answer 50 questions in 15 minutes.
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  • Match each statement with the correct term.
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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. Indicates add-on codes






3. When a group of employees and their dependents are insured under one (1) group policy issued to the employer. Generally - the employer pays the premium or a portion of the premium and the employee pays the difference. This all depends on the type of






4. This is located in the Index under the main term 'Neoplasm' and is organized by anatomic site. Each site has six columns with six possible codes determined by whether the neoplasm is malignant - benign - of uncertain behavior - or of unspecified natu






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






6. A medical record is documentation on the patient's social and medical history - family history - physical examination findings - progress notes - radiology and lab results - consultation reports and correspondence to patient.






7. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.






8. is defined as one who has not received any medical services within the last three years.






9. forms the back of the skull. There is a large hole at the ventral surface in this bone - called the foramen magnum - which allows the brain communication with the spinal cord






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






11. Is the lower medial arm bone.






12. 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.






13. Is when two insurance companies work together to coordinate payment of the benefits.






14. means the provider agrees to accept what the insurance company approves as payment in full for the claim.






15. Represents a new procedure or service code added since the previous edition of the manual.






16. Is a term used when a patient is admitted to the hospital with the expectation that the patient will stay for a period of 24 hours or more.






17. This involves the use of relative value scales which assign a relative weight to individual services according to the basis for the scale. Services that are more difficult - time consuming - or resource intensive to perform typically have higher rela






18. The cuticle at the lower part of the nail and this is sometimes referred to as the






19. Is an electronic or paper-based report of payment sent by the payer to the provider.






20. The lower anterior part of the bone






21. Standard - fee-for-service - cost-sharing plan ; Extra - preferred provider organization ;Prime - health maintenance organization plan with a point-of-service option All of the above-mentioned plans covered under TRICARE - with the exception of Prime






22. The moon like white area at the base of the nail.






23. Bone that forms posterior/inferior part of the nasal septal wall between the nostrils.






24. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.






25. 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






26. 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.






27. 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'.






28. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients






29. The reason the patient came to see the physician.






30. This is attached to the code of the E/M service provided to a patient during the postoperative period to indicate that that service is not part of the postoperative care which is usually part of a package of services of the surgery performed. Major s






31. Are located in the dermal layer of the skin over the entire body - except for the palms of the hands and soles of the feet. The sebaceous glands secrete an oily substance called sebum. Sebum contains lipids that help lubricate the skin and minimize w






32. 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






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






34. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.






35. The poisoning was self-inflicted.






36. Represents a new procedure or service code added since the previous edition of the manual.






37. Small collection of clear fluid;blister






38. A medical record is documentation on the patient's social and medical history - family history - physical examination findings - progress notes - radiology and lab results - consultation reports and correspondence to patient.






39. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)






40. Is a state-required insurance plan - the coverage of which provides benefits to employees and their dependents for work related injury - illness or death. Each state has an established minimum number of employees required before this law comes into e






41. This modifier is used to indicate that the procedure was done by an outside laboratory and not by the reporting facility or clinic.






42. cancer that is localized and has not spread to adjacent tissues or distant parts of the body






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






44. Was developed to promote the interests and well being of the patients and residents of the healthcare facility. This bill has still not become a law.

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






46. - is a procedure or service provided without proper authorization or was not covered by a current authorization. The claim is denied and the provider cannot bill the patient for the charges.






47. The spinal /vertebral column is divided into five regions from the neck to the tailbone. There are 26 bones in the spine and they are referred to as the vertebrae. The following list explains the bones of the spine: Cervical -Neck Bones -Thoracic -U






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






49. Is a fee that is charged for each procedure or service performed by the physician. This fee is obtained from a fee schedule - which is a list of charges or allowance that have accepted for specific medical services. The system in which fee schedules






50. Small collection of clear fluid;blister