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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. Structural protein found in the skin and connective tissue






2. This modifier is used to indicate that the procedure or service provided during the postoperative period was not associated with the initial procedure. Payment for the full fee of the subsequent procedure is requested and a new global period starts.






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






4. 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.






5. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.






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






7. 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






8. 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.






9. Is a statement of the patient's account history - showing dates of service - detailed charges - payments (i.e. deductibles and co-pays) - the date the insurance claim was submitted - applicable adjustments and account balance.






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






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






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






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






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






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






16. 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.






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






18. Are the finger bones. Each finger has three phalanges - except for the thumb. The three phalanges are the proximal - middle and a distal phalanx. The thumb has a proximal and distal.






19. Groove or crack like sore






20. 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.






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






22. 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.






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






24. 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






25. This is the inventory of the constitutional symptoms regarding the various body systems.






26. 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....






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






28. The spinal /vertebral column is divided into five regions from the neck to the tailbone. There are 26 bones in the spine and they are referred to as the vertebrae. The following list explains the bones of the spine: Cervical -Neck Bones -Thoracic -U






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






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






32. Superior and widest bone






33. 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






34. 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.'






35. Are codes formulated thru the joint efforts of the CMS - the Health Insurance Association of America - and the Blue Cross and Blue Shield Association. Level II contains five position alpha-numeric codes for physician and non-physician services not fo






36. This is a set of information the physician gathers from the patient regarding the following:






37. .. lower jaw bone.






38. Deficient in pigment (melanin)






39. 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 -






40. Number assigned by the insurance company to a physician who renders services to patients.






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






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






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






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






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






46. is defined as one who has not received any medical services within the last three years.






47. 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






48. 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






49. 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






50. 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