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






2. most synarthroses are immovable joints held together by fibrous tissue.






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






4. 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..






5. They are for profit organizations that operate in the private sector selling different health insurance benefits plans to groups or individuals. Most commercial plans have predefined patient yearly deductibles and coinsurance generally based on 80/2






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






7. Is to determine the patient's benefits and the maximum dollar amount that the insurance company will pay. Often the first step of the insurance verification process - it is completed prior to the first visit.






8. Is the qualifying factor or factors that must be met before a patient receives benefits.






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






10. uncertain whether benign or malignant; borderline malignancy






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






12. Under this schedule - a procedure's relative value is the sum total of three elements: Work: represents the amount of time - intensity of effort - and medical skill required of the physician. Overhead: practice costs related to the performing of the

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






14. Discolored - flat lesion (freckles - tattoo marks)






15. 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






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






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






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






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






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






21. death of tissue associated with loss of blood supply






22. 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.






23. 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.






24. Is a group of two or more physicians and non-physician practitioners legally organized in a partnership - professional corporation - foundation - not-for-profit corporation - faculty practice plan - or similar association.






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






26. The CPT Index is arranged in alphabetical order by main terms which are further divided by subterms. There are five location methods: 1. Service or Procedure 2. Anatomic site 3. Condition or Disease 4. Synonym/Eponym 5. Abbreviation






27. This is an alternative to paper claims submitted to the third-party payer directly by the physician or through a clearinghouse. Electronic claims are usually paid faster than paper claims and most electronic claims software have self-editing features






28. All patients have a right to privacy and all information should remain privileged. Discuss patient information only with the patient's physician or office personnel that need certain information to do their job. Obtain a signed consent form to releas






29. 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






30. numbers 8-10 - are attached to the sternum by cartilage






31. Further classified as to primary - secondary - or carcinoma in situ.






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






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






34. 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.






35. 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.






36. 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.






37. Superior and widest bone






38. The bone is broken and pierces an internal organ






39. requires investigation and needs further clarification.






40. - To pay for medical services and items that Medicare does not cover and Medicare's coinsurance and deductibles - beneficiaries may purchase a supplemental insurance. Medigap is a private insurance designed to help pay for those amounts that are typ






41. .. lower jaw bone.






42. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.






43.






44. 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






45. 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






46. 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.






47. 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.






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






49. 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.






50. is basically the same as HMO in the sense that the health care provider enters into contract with the MCOs to render services to the beneficiaries. However - PPO's charge a higher premium than HMO's in exchange for more flexibility and more options