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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. 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






2. This is the inventory of the constitutional symptoms regarding the various body systems.






3. Law passed by the federal government to prosecute cases of Medicaid fraud.






4. Is a regionally managed healthcare program for active duty and retired members of the armed forces - their families - and survivors. It is a service benefit program and contains no premium. TRICARE is the new title for the CHAMPUS program (Civilian H






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






6. Created the Health Care Fraud and Abuse Control Program enacted to check for fraud and abuse in the Medicare and Medicaid programs - and private payers.






7. major skin pigment






8. open sore on the skin or mucous






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






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






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






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






13. This is any procedure or service reported on the insurance claim that is not listed in the payer's master benefit list. This will result in the denial of the claim. Providers may be able to recover the charges from the patient.






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






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






16. Is a statement of the patient's account history - showing dates of service - detailed charges - payments (i.e. deductibles and co-pays) - the date the insurance claim was submitted - applicable adjustments and account balance.






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






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






19. 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






20. 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)






21. 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






22. Are supplemental codes used for performance measurements. Although these codes are intended to facilitate data collection about the quality of care - their use is optional. Category II codes are published twice a year: January 1st and July 1st.






23. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.






24. 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.






25. Contains complete - necessary information - but is incorrect or illogical in some way.






26. is a traumatic injury to a joint involving the soft tissue.






27. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the






28. Is a managed care benefits plan that provides a wide range of medical services to individuals that have been enrolled into the program. It is generally the least costly but at the same time also the most restrictive. This plan uses a gatekeeper physi






29. 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).






30. 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






31. Is the lower medial arm bone.






32. make up part of the roof of the mouth






33. Superior and widest bone






34. The fractured area of bone collapses on itself.






35. Small collection of clear fluid;blister






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






37. The plan of the parent whose birthday falls earlier in the year (month and day - not year) is primary to that whose birthday falls later in the year. If both parents have the same birthday - then the plan of the parent who has had the longest coverag






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






39. the bone is crushed and or shattered.






40. Is a managed care plan that gives beneficiaries the option whom to see for services. If the beneficiary goes to see a physician within the network - s/he will receive benefits similar to an HMO. But if the beneficiary chooses to see a physician from






41. This modifier is used to indicate that the procedure or service provided during the postoperative period was not associated with the initial procedure. Payment for the full fee of the subsequent procedure is requested and a new global period starts.






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






43. 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.






44. Prescription Drugs The Medicare Prescription Drug - Improvement - and Modernization Act enacted in December 2003 and began implementation in January 2006 where Medicare beneficiaries can enroll in the Medicare prescription drug plan. The beneficiari






45. 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:






46. 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






47. Is a statement of the patient's account history - showing dates of service - detailed charges - payments (i.e. deductibles and co-pays) - the date the insurance claim was submitted - applicable adjustments and account balance.






48. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.






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






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