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






2. 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....






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






4. 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)






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






6. Deficient in pigment (melanin)






7. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.






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






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. Are wrist bones. There are 2 rows of four bones in the wrist. The metacarpals are the five radiating bones in the fingers. These are the bones in the palm of the hand.






11. Are wrist bones. There are 2 rows of four bones in the wrist. The metacarpals are the five radiating bones in the fingers. These are the bones in the palm of the hand.






12. 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






13. Deficient in pigment (melanin)






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






15. 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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16. Various terms are used to describe the state of submitted forms. The following are some of the terms that are typically used by insurance carriers.






17. 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.






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






19. Considered experimental - newly approved - or seldom used may not be listed in the CPT manual. These codes can be coded as unlisted procedures. They are located at the end of the subsections or subheadings. When an unlisted procedure code is reported






20. Cheekbone






21. Describes the services billed and includes a breakdown of how the payment is determined






22. 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






23. 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






24. the bone is crushed and or shattered.






25. is one who has not received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years.






26. Typically not used on the claim form unless the provider does not have an EIN.






27. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.






28. Provide the means by which the reporting physician can indicate that a service or procedure that has been performed has been altered by some specific circumstance but not changed in its definition or code.






29. 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






30. 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






31.






32. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.






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






34. 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.






35. Forms the anterior part of the skull and the forehead






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






37. 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.






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






39. is one who has not received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years.






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






41. Was created to provide medical benefits to spouses and children of veterans with total - permanent service related disabilities or for surviving spouses and children of a veteran who died as a result of service-related disability. It is a service ben






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






43. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).






44. 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






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






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






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






48. Any fracture occurring spontaneously as a result of disease.






49. The bone is broken and pierces an internal organ






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