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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. Any fracture occurring spontaneously as a result of disease.






2. 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






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






4. 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






5. 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






6. Used for procedures that is always performed during the same operative session as another surgery in addition to the primary service/procedure and is never performed separately.






7. Is a document provided to a Medicare beneficiary by a provider prior to service being rendered letting the beneficiary know of his/her responsibility to pay if Medicare denies the claim.






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






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






10. Indicates add-on codes






11. 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.






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






13. 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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14. Is a policy that covers losses to a third party caused by the insured - by an object owned by the insured - or on premises owned by the insured. Liability insurance claims are made to cover the cost of medical care for traumatic injuries - lost wages






15. Is the lower medial arm bone.






16. anterior to the temporal bones.






17. uncertain whether benign or malignant; borderline malignancy






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






19. Is an electronic or paper-based report of payment sent by the payer to the provider.






20. Absence of hair from areas where it normally grows






21. Number assigned to the physician by Medicare program.






22. When a group of employees and their dependents are insured under one (1) group policy issued to the employer. Generally - the employer pays the premium or a portion of the premium and the employee pays the difference. This all depends on the type of






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






24. .. lower jaw bone.






25. 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






26. Is the cost of insurance coverage paid annually - semi-annually or monthly to keep a policy in effect.






27. 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






28. 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....






29. Are composed of three-digit codes representing a single disease or condition.






30. This is the traditional method used by providers for submission of charges to insurance companies. The most commonly used form is the CMS-1500. Few plans still accept the physician's encounter form or superbill and Medicare will only accept claims on






31. 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.






32. 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.






33. Structural protein found in the skin and connective tissue






34. 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.






35. 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.






36. 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:






37. uncertain whether benign or malignant; borderline malignancy






38. make up part of the roof of the mouth






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






40. Groove or crack like sore






41. 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.






42. 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.






43. 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






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






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






46. They are for profit organizations that operate in the private sector selling different health insurance benefits plans to groups or individuals. Most commercial plans have predefined patient yearly deductibles and coinsurance generally based on 80/2






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






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






49. 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.






50. Represents a new procedure or service code added since the previous edition of the manual.






Can you answer 50 questions in 15 minutes?



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