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






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






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






4. 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






5. The poisoning was self-inflicted.






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






7. 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






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






9. .. lower jaw bone.






10. 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






11. 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






12. Also called 'global surgery' - includes a variety of services rendered by a surgeon which includes the following: Surgical procedure performed Local infiltration - metacarpal/metatarsal/digital block - or topical anesthesia Preoperative E/M services






13. male of household is primary payer






14. The bone is broken and pierces an internal organ






15. Poisoning cannot be determined whether intentional or accidental.






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






17. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.






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






19. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)






20. Structural protein found in the skin and connective tissue






21. 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






22. 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






23. Groove or crack like sore






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






25. 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






26. Are a group of independently licensed local companies - usually nonprofit that contracts with physicians and other health entities to provide services to their insured companies and individuals. Most BC/BS plans offer HMO's - PPO's and POS plans. Blu






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






28. The musculoskeletal system includes the bones - muscles - and joints The musculoskeletal system acts as a framework for the organs - protects many of those organs - and also provides the organism the ability to move..






29. 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






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






31. Physicians are legally responsible for their own conduct and any actions of their employees (their designee) performed within the context of their employment. This is referred to as 'vicarious liability -' also known as 'respondent superior -' which






32. open sore on the skin or mucous






33. 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.






34. Medicare Managed Care Plans (Formerly Medicare Plus (+) Choice Plan) was created to offer a number of healthcare services in addition to those available under Part A and Part B. The CMS contracts with managed care plans or provider service organizati






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






36. - 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.






37. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.






38. 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






39.






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






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






42. 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'.






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






44. 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).






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






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






47. 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.






48. uncertain whether benign or malignant; borderline malignancy






49. 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






50. 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'.