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Medical Billing And Coding Vocab

Instructions:
  • Answer 50 questions in 15 minutes.
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  • Match each statement with the correct term.
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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. Further classified as to primary - secondary - or carcinoma in situ.






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






3. Deficient in pigment (melanin)






4. Is defined as someone who has received medical services with in the last 3 years from the physician or another physician of the same specialty who belongs to the same group practice.






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






6. is defined as reimbursement for income lost as a result of a temporary or permanent illness or injury. When patients are treated for disability diagnoses and other medical problems - separate patient records must be maintained. Disability insurance






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






8. Was developed to promote the interests and well being of the patients and residents of the healthcare facility. This bill has still not become a law.

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9. 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






10. Also known as Federal tax identification number. This is issued by the Internal Revenue Service






11. 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






12. Forms the sides of the cranium






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






14. 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






15. 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.






16. Indicates add-on codes






17. 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






18. 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






19. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.






20. A pregnant woman who has had at least one previous pregnancy.






21. 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






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






23. .. lower jaw bone.






24. Codes from the CPT codebook are used to report services and procedures by physicians. It is published and updated annually by the American Medical Association (AMA) with a new one coming out each November and becoming effective on January 1st of the






25. The reason the patient came to see the physician.






26. There are also terms indented two spaces to the right below the main term called subterms. These subterms are because they have bearing in the selection of the right code. Everything in the Index is listed by condition - that is - diagnosis - signs -






27. Contain the full description of the procedure for the code indented codes: these are codes listed under associated stand-alone codes. To complete the description for indented codes - one must refer to the portion of the stand alone code description b






28. 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






29. 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:






30. This is used to indicate that the service provided was required by a third-party payer - governmental - legislative - or regulatory body. This does not include second opinion requested by a patient - family member - or another physician.






31. A fat cell






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






33. The physician must obtain this number in order to practice within a state.






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






35. death of tissue associated with loss of blood supply






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






37. Is defined by Medicare as 'the determination that a service or procedure rendered is reasonable and necessary for the diagnosis or treatment of an illness or injury.'






38. 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






39. 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.






40. the bone is crushed and or shattered.






41. 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.






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






43. 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.






44. 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






45. Most procedures have both professional (physician) and technical components. This modifier is attached to the procedure to indicate that the physician provided only the professional component.






46. Eccrine sweat glands are the most common and the apocrine sweat glands that secrete an odorless sweat.






47. 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.






48. make up part of the roof of the mouth






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






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