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






2. This modifier is used when: more than one procedure is performed during the same surgical episode; one code does not describe all of the procedures performed; and the secondary procedure is not minor or incidental to the major procedure. The followin






3. Noninvasive - non-spreading - nonmalignant






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






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






6. 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






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






8. 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






9. 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....






10. 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






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






12. 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.






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






14. open sore on the skin or mucous






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






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






17. 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






18. Is the type of plan a patient may have where they can see providers outside their plan. The patient is responsible to pay the higher portion of the fee.






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






20. Poisoning cannot be determined whether intentional or accidental.






21. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.






22. 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






23. 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..






24. 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






25. Deficient in pigment (melanin)






26. 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.






27. A fracture of the epiphyseal plate in children.






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






29. Mild or controlled hypertension and no damage to the vascular system or organs.






30. 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






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






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






33. 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






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






35. Retention of medical records is governed by state and local laws and may vary from state-to-state. Most physicians are required to retain records indefinitely; deceased patient records should be kept for at least five (5) years.






36. Is a requirement for some health insurance plans to obtain permission for a service or procedure before it is done. It indicates that a specific procedure or service is deemed 'medically necessary'.






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






38. 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.






39. 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.






40. The lower anterior part of the bone






41. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients






42. The CPT manual is composed of eight sections. Each section begins with guidelines that provide specific coding rules for that section. Guidelines at the beginning of the section are applicable to all codes in the section - while notes that pertain t






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






44.






45. This is attached to the code of the E/M service provided to a patient during the postoperative period to indicate that that service is not part of the postoperative care which is usually part of a package of services of the surgery performed. Major s






46. 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






47. 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






48. 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






49. 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






50. 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.