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






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






3. Provide the means by which the reporting physician can indicate that a service or procedure that has been performed has been altered by some specific circumstance but not changed in its definition or code.






4. death of tissue associated with loss of blood supply






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






6. 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.






7. 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.






8. Most billing-related cases are based on HIPAA and False Claims Act.






9. consists of 17 chapters based on either body system or cause or type of disease. The codes range from 001-999.






10. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.






11. 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.






12. Is defined as a doctor of medicine or osteopathy - dental medicine - dental surgery - podiatric medicine - optometry - or chiropractic medicine legally authorized to practice by the state in which he/she performs.






13. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.






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






16. Is the federal government's health insurance program created by the Social Security Act of 1965 titled 'Health Insurance for the Aged and Disabled'. It is administered by the Centers for Medicare and Medicaid Services (CMS) - formerly known as Health






17. All patients have a right to privacy and all information should remain privileged. Discuss patient information only with the patient's physician or office personnel that need certain information to do their job. Obtain a signed consent form to releas






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






19. means the provider agrees to accept what the insurance company approves as payment in full for the claim.






20. 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.






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






22. the bone is crushed and or shattered.






23. Are temporary codes for emerging technology - services and procedures. If a Category III code is available - it is reported instead of a Category I unlisted code.






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






25. 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.






26. 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.






27. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.






28. Developed by the CMS to promote national correct coding methodologies and to control improper coding that leads to inappropriate payment of Part B health insurance claims.






29. are small with irregular shapes. They are found in the wrist and ankle.






30. 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






31. 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.






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






33. HCPCS Reference Manual The CMS assigns a standard unique identifier known as the National Provider Identifier (NPI) The CMS also developed a two-part coding system called the Healthcare Common Procedure Coding System ( HCPCS ) which is a collection o






34. 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 -






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






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






37. This is located in the Index under the main term 'Neoplasm' and is organized by anatomic site. Each site has six columns with six possible codes determined by whether the neoplasm is malignant - benign - of uncertain behavior - or of unspecified natu






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






39. Typically not used on the claim form unless the provider does not have an EIN.






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






41. Is a fee that is charged for each procedure or service performed by the physician. This fee is obtained from a fee schedule - which is a list of charges or allowance that have accepted for specific medical services. The system in which fee schedules






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






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






44. 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.






45. Is defined as a doctor of medicine or osteopathy - dental medicine - dental surgery - podiatric medicine - optometry - or chiropractic medicine legally authorized to practice by the state in which he/she performs.






46. The moon like white area at the base of the nail.






47. 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






48. Is a working diagnosis which is not yet established.






49. 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






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