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






2. The main term in the index may by followed by terms within parenthesis.






3. - 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.






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. Noninvasive - non-spreading - nonmalignant






6. An insurance plan issued to an individual. Premium rates are usually higher than group rates and service availability is lessened with this type of coverage.






7. 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.






8. male of household is primary payer






9. Represent changes in the text or definition between the triangles.






10. Groove or crack like sore






11. Federal law that prohibits submitting a fraudulent claim or making a false statement or representation in connection with a claim. It also protects and rewards persons involved in whistle-blower cases.






12. This is not specified as benign or malignant in the diagnosis or medical record.






13. 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:






14. 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.






15. Is a percentage of the cost of covered services that a policyholder or a secondary insurance pays. A common payment percentage for coinsurance is 80/20 which indicates that 20% is the coinsurance for which the beneficiary or secondary insurance is re






16. This modifier is used to explain that the procedure or service done during a postoperative period was planned at the time of the original procedure. This is also used if a therapeutic procedure is performed because of the findings from a diagnostic p






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






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






19. 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.






20. Represent services and procedures widely used by many health care professionals in clinical practice in multiple locations and have been approved by the FDA.






21. 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....






22. Is a patient who receives treatment in any of the following settings: physician's office ;hospital clinic - emergency department - hospital same-day surgery unit - ambulatory surgical center ( patient is released within 23 hours) ;hospital admission






23. The epidermis - the dermis - and the subcutaneous layer. The epidermis is a thin - cellular membrane layer that contains keratin. The dermis is a dense - fibrous - connective tissue that contains collagen. The subcutaneous layer is a thicker and fatt






24. 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






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






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






27. 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






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






29. The lower anterior part of the bone






30. Produce secretions that allow the body to be moisturized or cooled.






31. the bone is broken and the ends are driven into each other.






32. The Usual - Customary - and Reasonable: The UCR method is used mostly in reference to fee-for-service reimbursement. To arrive at a payment amount for a claim - the carrier compares: The physician's most frequent charge for a given service (the usual






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






34. Is an entity that receives transmissions of claims from physicians' offices - separates the claims by carriers and performs software edits on each claim to check for errors. Once this process is complete - the claim is then sent to the proper insuran






35. 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






36. This modifier is used when the same procedure is performed on a mirror-image part of the body..






37. Physicians agree to provide services at a discount of their usual fee in return for a pool of existing patients.






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






39. 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






40. Structural protein found in the skin and connective tissue






41. cancer that is localized and has not spread to adjacent tissues or distant parts of the body






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






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






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






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






46. Poisoning was due to: Accidental overdose; Wrong substance taken; Accidents in use of drugs and biologicals; External causes of poisonings classifiable to 980-989 Therapeutic Use: instances when a correct substance properly taken is the cause of adve






47. 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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48. forms the roof of the nasal cavity.






49. This is also known as fee-for-service. Under this plan - the services that are paid for are listed in the policy and payments are based on the fees physicians charge for the service. Each year - the beneficiary must meet a deductible - after which -






50. Upper jaw bone