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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. 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.






2. make up part of the roof of the mouth






3. A fracture of the epiphyseal plate in children.






4. Are supplementary classification codes used to identify health care encounters that occur for reasons other than illness or injury or to identify patients whose illness is influenced by special circumstances or problems. The codes can be found in bot






5. A minor fracture appears as a thin line on x-ray and may not extend completely through the bone.






6. Indicates add-on codes






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






8. 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....






9. Produce secretions that allow the body to be moisturized or cooled.






10. Are temporary codes for emerging technology - services and procedures. If a Category III code is available - it is reported instead of a Category I unlisted code.






11. male of household is primary payer






12. 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






13. Under capitation - the physician provides a full range of contracted services to covered patients for a fixed amount on a periodic basis. While guaranteed a fixed amount - the physician assumes the risk that the cost of providing the care to the pati






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






15. Is the cost of insurance coverage paid annually - semi-annually or monthly to keep a policy in effect.






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






17. This is the index for the E codes.It classifies - in alphabetical order - environmental events and other conditions as the cause of injury and other adverse effects.






18. A physician has a separate PPIN for each group office/clinic in which he or she practices. In the Medicare program - in addition to a group number - each member of a group is issued an 8-character performing provider identification number.






19. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body






20. Mild or controlled hypertension and no damage to the vascular system or organs.






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






22. Small collection of clear fluid;blister






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






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






25. Poisoning was due to: Accidental overdose; Wrong substance taken; Accidents in use of drugs and biologicals; External causes of poisonings classifiable to 980-989 Therapeutic Use: instances when a correct substance properly taken is the cause of adve






26. 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.






27. poisoning was inflicted by another person with intent to kill or injure






28. Are temporary codes for emerging technology - services and procedures. If a Category III code is available - it is reported instead of a Category I unlisted code.






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






30. 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.






31. The skin and its accessory organs.Integument means covering. The skin covers over an area of 22 square feet ( an average adult). It is a complex system of specialized tissues containing glands - nerves and blood vessels. The main function of the skin






32. Superior and widest bone






33. 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.






34. 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






35. This is also known as fee-for-service. Under this plan - the services that are paid for are listed in the policy and payments are based on the fees physicians charge for the service. Each year - the beneficiary must meet a deductible - after which -






36. Is made up of the shoulder - collar - pelvic and arms and legs






37. HCPCS Reference Manual The CMS assigns a standard unique identifier known as the National Provider Identifier (NPI) The CMS also developed a two-part coding system called the Healthcare Common Procedure Coding System ( HCPCS ) which is a collection o






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






39. This number is used instead of the individual physician's number for the performing provider who is a member of a group practice that submits claims to insurance companies under the group name.






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






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






42. 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.






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






44. Includes - but is not limited to - physician assistant - certified nurse-midwife - qualified psychologist - nurse practitioner - clinical social worker - physical therapist - occupational therapist - respiratory therapist - certified registered nurse






45. 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






46. 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....






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






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






49. 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'.






50. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.