Test your basic knowledge |

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. Is the lateral lower arm bone (in line with the thumb).






2. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.






3. 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'.






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






5. numbers 8-10 - are attached to the sternum by cartilage






6. The lower anterior part of the bone






7. 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






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






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






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






11. Forms the sides of the cranium






12. 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






13. 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.






14. 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






15. anterior to the temporal bones.






16. forms the roof of the nasal cavity.






17. major skin pigment






18. 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






19. Numbers 1-7 - attach directly to the sternum in the front of the body.






20. 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 -






21. Cheekbone






22. Knowingly and intentionally deceiving or misrepresenting information that may result in unauthorized benefits is known as fraud.. Common forms of fraud are billing for services not furnished - unbundling - and misrepresenting diagnosis to justify pay






23. 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






24. Noninvasive - non-spreading - nonmalignant






25. .. lower jaw bone.






26. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.






27. Discolored - flat lesion (freckles - tattoo marks)






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






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






30. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.






31. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.






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






33. the bone is crushed and or shattered.






34. Are supplementary classification codes used to identify health care encounters that occur for reasons other than illness or injury or to identify patients whose illness is influenced by special circumstances or problems. The codes can be found in bot






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






36. Prescription Drugs The Medicare Prescription Drug - Improvement - and Modernization Act enacted in December 2003 and began implementation in January 2006 where Medicare beneficiaries can enroll in the Medicare prescription drug plan. The beneficiari






37. Indicates add-on codes






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






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






40. 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






41. Are small - rounded bones that resemble a sesame seed. They are found near joints and increase the efficiency of muscles near a joint. An example of sesamoid bone is the knee cap.






42. paired bones at the corner of each eye that cradle the tear ducts.






43. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.






44. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.






45. 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






46. Has all required fields accurately filled out - contains no deficiencies and passes all edits. The carrier does not require investigation outside of the carrier's operation before paying the claim.






47. Are small - rounded bones that resemble a sesame seed. They are found near joints and increase the efficiency of muscles near a joint. An example of sesamoid bone is the knee cap.






48. The skin and its accessory organs.Integument means covering. The skin covers over an area of 22 square feet ( an average adult). It is a complex system of specialized tissues containing glands - nerves and blood vessels. The main function of the skin






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






50. Was created to provide medical benefits to spouses and children of veterans with total - permanent service related disabilities or for surviving spouses and children of a veteran who died as a result of service-related disability. It is a service ben