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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. Codes from the CPT codebook are used to report services and procedures by physicians. It is published and updated annually by the American Medical Association (AMA) with a new one coming out each November and becoming effective on January 1st of the






2. This modifier is used to indicate that the procedure was done by an outside laboratory and not by the reporting facility or clinic.






3. Make up part of the interior of the nose.






4. 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






5. Absence of hair from areas where it normally grows






6. Is the upper arm bone.






7. The bone is broken and pierces an internal organ






8. forms the two lower sides of the cranium.






9. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.






10. Indicates add-on codes






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






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






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






14. 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.






15. provides a five-digit code which gives the highest specificity of description to a condition. Use of it is mandatory if it is available. A code not reported to the full number of digits required is invalid. e.g. 240.01 Toxic diffuse goiter with thyr






16. Is when two insurance companies work together to coordinate payment of the benefits.






17. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).






18. found in the Index under the main term 'Hypertension' - and it contains a list of conditions that are due to or associated with hypertension. The table classifies the conditions as:






19. Federal law that prohibits submitting a fraudulent claim or making a false statement or representation in connection with a claim. It also protects and rewards persons involved in whistle-blower cases.






20. represents Exemption from the use of modifier -51






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






22. 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.






23. 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.






24. 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






25. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)






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






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






28. 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






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






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






31. Is a state-required insurance plan - the coverage of which provides benefits to employees and their dependents for work related injury - illness or death. Each state has an established minimum number of employees required before this law comes into e






32. 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.






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






34. Poisoning cannot be determined whether intentional or accidental.






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






36. 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.






37. 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






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






39. 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






40. This modifier is used to indicate that the procedure was done by an outside laboratory and not by the reporting facility or clinic.






41. 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






42. An insurance plan issued to an individual. Premium rates are usually higher than group rates and service availability is lessened with this type of coverage.






43. 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






44. This modifier is used to report a procedure or service that has more than one Modifier but the third-party payer does not allow the addition of multiple modifiers to the code. Modifier -99 is attached to the procedure code and the multiple Modifiers






45. Groove or crack like sore






46. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).






47. 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.






48. Noninvasive - non-spreading - nonmalignant






49. 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.






50. 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.