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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. It is important that every patient seen by the physician has comprehensive legible documentation about the patient's illness - treatment and plans for the following reasons Avoidance of denied or delayed payments by insurance carriers investigating t






2. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.






3. make up part of the roof of the mouth






4. 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.'






5. A chronological account of the development of the complaint from the first sign or symptom that the patient experienced to the present






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






7. The lower anterior part of the bone






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






9. 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.






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






11. Unlike the RBRVS - the RVP has no geographic adjustment factor or individual RVU component to calculate. However - for each category of procedures - a separate conversion factor must be developed....






12. Are supplementary classification codes used to describe the reason or external cause of injury - poisoning and other adverse effects. These codes can be found in both Volumes I and II. E codes are used to classify environmental events - circumstances






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






14. This is the index for the E codes.It classifies - in alphabetical order - environmental events and other conditions as the cause of injury and other adverse effects.






15. 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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16. 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.






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






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






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






20. .. lower jaw bone.






21. 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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22. To report a circumstance in which the physician returns to the operating room to address a complication stemming from the initial procedure - modifier -78 is attached to the subsequent procedure code.






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






24. 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






25. is a federal program administered by state governments to provide medical assistance to the needy. Each state sets its own guidelines for eligibility and services - therefore benefits and coverage may vary widely from state to state.






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






27. The poisoning was self-inflicted.






28. It is important that every patient seen by the physician has comprehensive legible documentation about the patient's illness - treatment and plans for the following reasons Avoidance of denied or delayed payments by insurance carriers investigating t






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






30. 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






31. 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






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






33. 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






34. 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






35. 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






36.






37. 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.






38. - 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.






39. Provide a four-digit code (one digit after the decimal point) which is more specific than category code (3-digit) in terms of cause - site - or manifestation of the condition. This must be used if available. From subcategory - specificity moves to an






40. 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.






41. requires investigation and needs further clarification.






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






43. 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.






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






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






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






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






49. Are conditions - situations - and services not covered by the insurance carrier.






50. 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..