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. the bone is broken and the ends are driven into each other.






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






3. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.






4. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.






5. Groove or crack like sore






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






7. Contain the full description of the procedure for the code indented codes: these are codes listed under associated stand-alone codes. To complete the description for indented codes - one must refer to the portion of the stand alone code description b






8. These parenthetic terms are called because their presence or absence does not have an effect on the selection of the code listed for the main term.






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






10. 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






11. 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






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






13. requires investigation and needs further clarification.






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






15. Contain the full description of the procedure for the code indented codes: these are codes listed under associated stand-alone codes. To complete the description for indented codes - one must refer to the portion of the stand alone code description b






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






17. The E&M section includes codes that pertain to the nature of the physicians' work. The codes depend on type of service - patient status - and place where service was rendered. The E&M section is divided into broad categories such as office visits - h






18. contains errors or omissions. Usually - these claims do not pass front-end edits. They are either processed manually for resolving problems - or rejected for payment.






19. 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






20. most synarthroses are immovable joints held together by fibrous tissue.






21. A pregnant woman who has had at least one previous pregnancy.






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






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






24. Lower portion of the pelvic bone






25. A physician has a separate PPIN for each group office/clinic in which he or she practices. In the Medicare program - in addition to a group number - each member of a group is issued an 8-character performing provider identification number.






26. This involves the use of relative value scales which assign a relative weight to individual services according to the basis for the scale. Services that are more difficult - time consuming - or resource intensive to perform typically have higher rela






27. 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






28. 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.






29. 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






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






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






32. 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.






33. Is a service performed by a physician whose opinion or advice is requested by another physician in the evaluation or treatment of a patient's illness or suspected problem. The consultant does not assume responsibility for the patient's care and must






34. This is defined as incidents or practices - not usually considered fraudulent - that are inconsistent with the accepted medical business or fiscal practices in the industry. Examples of abuse are submitting a claim for a service or procedure performe






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






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






37. 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.






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






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






40. Deficient in pigment (melanin)






41. Is a regionally managed healthcare program for active duty and retired members of the armed forces - their families - and survivors. It is a service benefit program and contains no premium. TRICARE is the new title for the CHAMPUS program (Civilian H






42. the bone is crushed and or shattered.






43. Is a cost-sharing requirement for the insured to pay at the time of service. This amount is usually a specific dollar amount (e.g.. $15 - $20 - $25)






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






45. 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.






46. Contains complete - necessary information - but is incorrect or illogical in some way.






47. 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






48. .. lower jaw bone.






49. requires investigation and needs further clarification.






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