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Medical Billing And Coding Vocab

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






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






3. Are wrist bones. There are 2 rows of four bones in the wrist. The metacarpals are the five radiating bones in the fingers. These are the bones in the palm of the hand.






4. Superior and widest bone






5. 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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6. 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 -






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






8. 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.






9. Is made up of the shoulder - collar - pelvic and arms and legs






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






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






12. 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






13. The CPT Index is arranged in alphabetical order by main terms which are further divided by subterms. There are five location methods: 1. Service or Procedure 2. Anatomic site 3. Condition or Disease 4. Synonym/Eponym 5. Abbreviation






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






15. Unlike the RBRVS - the RVP has no geographic adjustment factor or individual RVU component to calculate. However - for each category of procedures - a separate conversion factor must be developed....






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. Unlike the RBRVS - the RVP has no geographic adjustment factor or individual RVU component to calculate. However - for each category of procedures - a separate conversion factor must be developed....






18. includes the shoulder girdle which is made up of the scapula - clavicle and upper extremities. The scapula - or shoulder blades are flat bones that help support the arms. The clavicle - or collarbone - is curved horizontal bones that attach to the u






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






20. 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.






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






22. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.






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






24. The lower anterior part of the bone






25. 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






26. 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






27. Is made up of the shoulder - collar - pelvic and arms and legs






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






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






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






31. This is not specified as benign or malignant in the diagnosis or medical record.






32. Forms the anterior part of the skull and the forehead






33. 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.






34. 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






35. 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.






36. 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.






37. Are supplementary classification codes used to describe the reason or external cause of injury - poisoning and other adverse effects. These codes can be found in both Volumes I and II. E codes are used to classify environmental events - circumstances






38. Poisoning was due to: Accidental overdose; Wrong substance taken; Accidents in use of drugs and biologicals; External causes of poisonings classifiable to 980-989 Therapeutic Use: instances when a correct substance properly taken is the cause of adve






39. 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.






40. 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






41. forms the roof of the nasal cavity.






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






43. 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






44. Families - pregnant women - and children ;Aid to Families with Dependent Children (AFDC)-related groups ;Non-AFDC pregnant women and children;Aged and disabled persons ;Supplemental Security Income (SSI)-related groups ;Qualified Medicare Beneficiari






45. Various terms are used to describe the state of submitted forms. The following are some of the terms that are typically used by insurance carriers.






46. This is used to indicate that the service provided was required by a third-party payer - governmental - legislative - or regulatory body. This does not include second opinion requested by a patient - family member - or another physician.






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






48. 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.






49. Superior and widest bone






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






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