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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. Eccrine sweat glands are the most common and the apocrine sweat glands that secrete an odorless sweat.






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






3. open sore on the skin or mucous






4. 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.






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






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






7. .. lower jaw bone.






8. The bone is broken and pierces an internal organ






9. the bone is crushed and or shattered.






10. 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






11. 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.






12. Provide a four-digit code (one digit after the decimal point) which is more specific than category code (3-digit) in terms of cause - site - or manifestation of the condition. This must be used if available. From subcategory - specificity moves to an






13. A fracture of the epiphyseal plate in children.






14. 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.






15. 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.






16. 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






17. 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






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






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






20. is one who has not received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years.






21. 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.






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






23. Prescription Drugs The Medicare Prescription Drug - Improvement - and Modernization Act enacted in December 2003 and began implementation in January 2006 where Medicare beneficiaries can enroll in the Medicare prescription drug plan. The beneficiari






24.






25. Lower portion of the pelvic bone






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






27. 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






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






29. 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.






30. 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






31. 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






32. A fat cell






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






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






35. 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






36. Is one who has no contract with the health insurance plan.






37. 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






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






39. forms the two lower sides of the cranium.






40. represents Exemption from the use of modifier -51






41. 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






42. Absence of hair from areas where it normally grows






43. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients






44. 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.






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






46. 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






47. 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.






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






49. Physicians are legally responsible for their own conduct and any actions of their employees (their designee) performed within the context of their employment. This is referred to as 'vicarious liability -' also known as 'respondent superior -' which






50. In July 2001 - the Health Care Financing Administration (HCFA) became the Centers for Medicare & Medicaid Services (CMS) - and the universal claim form HCFA-1500 became the CMS-1500.Virtually all third-party payers will accept it - and Medicare requ