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Medical Billing And Coding Vocab

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  • Answer 50 questions in 15 minutes.
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  • Match each statement with the correct term.
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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. Indicates add-on codes






2. anterior to the temporal bones.






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






4. 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






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






6. are composed of a group of three-digit categories representing a group of conditions or related conditions; they are divided into categories. e.g. . - Disorders of Thyroid Gland (240 - 246).






7. Are located in the dermal layer of the skin over the entire body - except for the palms of the hands and soles of the feet. The sebaceous glands secrete an oily substance called sebum. Sebum contains lipids that help lubricate the skin and minimize w






8. A medical record is documentation on the patient's social and medical history - family history - physical examination findings - progress notes - radiology and lab results - consultation reports and correspondence to patient.






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






10. 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.'






11. Cheekbone






12. 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 -






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






14. 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.






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






16. Cheekbone






17. Under this schedule - a procedure's relative value is the sum total of three elements: Work: represents the amount of time - intensity of effort - and medical skill required of the physician. Overhead: practice costs related to the performing of the

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18. 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






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






20. 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






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






22. requires investigation and needs further clarification.






23. Deficient in pigment (melanin)






24. 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






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






26. - is a procedure or service provided without proper authorization or was not covered by a current authorization. The claim is denied and the provider cannot bill the patient for the charges.






27. 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






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






29. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.






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






31. Structural protein found in the skin and connective tissue






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






33. Standard - fee-for-service - cost-sharing plan ; Extra - preferred provider organization ;Prime - health maintenance organization plan with a point-of-service option All of the above-mentioned plans covered under TRICARE - with the exception of Prime






34. open sore on the skin or mucous






35. 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






36. The fractured area of bone collapses on itself.






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






38. 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.






39. 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.






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






41. 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.






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






43. is a traumatic injury to a joint involving the soft tissue.






44. 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.






45. 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.






46. Number assigned to the physician by Medicare program.






47. This number is used instead of the individual physician's number for the performing provider who is a member of a group practice that submits claims to insurance companies under the group name.






48. is referred to as Supplementary Medical Insurance (SMI). This coverage is a supplement to Part A - which covers medical expenses - clinical laboratory services - home health care - outpatient hospital treatment - blood - and ambulatory surgical serv






49. 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






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







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