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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.
  • 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. represents Exemption from the use of modifier -51






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






3. 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






4. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.






5. 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






6. 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.






7. is defined as one who has not received any medical services within the last three years.






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






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






10. 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






11. This involves the use of relative value scales which assign a relative weight to individual services according to the basis for the scale. Services that are more difficult - time consuming - or resource intensive to perform typically have higher rela






12. 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.






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






14. Numbers 1-7 - attach directly to the sternum in the front of the body.






15. Also known as Federal tax identification number. This is issued by the Internal Revenue Service






16. 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.






17. 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).






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






19. 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.






20. Upper jaw bone






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






22. 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.






23. 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






24. numbers 8-10 - are attached to the sternum by cartilage






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






26. 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.






27. 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






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






29. 'Errors and omissions insurance' is protection against loss of monies caused by failure through error or unintentional omission on the part of the individual or service submitting the insurance claim. Some physicians' contract with a billing service






30. poisoning was inflicted by another person with intent to kill or injure






31. The musculoskeletal system includes the bones - muscles - and joints The musculoskeletal system acts as a framework for the organs - protects many of those organs - and also provides the organism the ability to move..






32. Cheekbone






33. Forms the sides of the cranium






34. 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.






35. Are composed of three-digit codes representing a single disease or condition.






36. 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.






37. The cuticle at the lower part of the nail and this is sometimes referred to as the






38. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.






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






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






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






42. 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






43. This modifier is used when: more than one procedure is performed during the same surgical episode; one code does not describe all of the procedures performed; and the secondary procedure is not minor or incidental to the major procedure. The followin






44. Are codes formulated thru the joint efforts of the CMS - the Health Insurance Association of America - and the Blue Cross and Blue Shield Association. Level II contains five position alpha-numeric codes for physician and non-physician services not fo






45. Includes - but is not limited to - physician assistant - certified nurse-midwife - qualified psychologist - nurse practitioner - clinical social worker - physical therapist - occupational therapist - respiratory therapist - certified registered nurse






46. Consists of the skull - rib cage - and spine






47. major skin pigment






48. .. lower jaw bone.






49. - To pay for medical services and items that Medicare does not cover and Medicare's coinsurance and deductibles - beneficiaries may purchase a supplemental insurance. Medigap is a private insurance designed to help pay for those amounts that are typ






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