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






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






3. 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






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






5. This modifier is used when the same procedure is performed on a mirror-image part of the body..






6. It is important that every patient seen by the physician has comprehensive legible documentation about the patient's illness - treatment and plans for the following reasons Avoidance of denied or delayed payments by insurance carriers investigating t






7. Structural protein found in the skin and connective tissue






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






9. 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






10. anterior to the temporal bones.






11. 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.






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






13. Is the upper arm bone.






14. 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.






15. Is a patient who receives treatment in any of the following settings: physician's office ;hospital clinic - emergency department - hospital same-day surgery unit - ambulatory surgical center ( patient is released within 23 hours) ;hospital admission






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






17. Is a group of two or more physicians and non-physician practitioners legally organized in a partnership - professional corporation - foundation - not-for-profit corporation - faculty practice plan - or similar association.






18. 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.






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






20. 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 -






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






22. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.






23. Represents a new procedure or service code added since the previous edition of the manual.






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






25. Indicates add-on codes






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






27. 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






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






29. represents Exemption from the use of modifier -51






30. forms the two lower sides of the cranium.






31. Contain the full description of the procedure for the code indented codes: these are codes listed under associated stand-alone codes. To complete the description for indented codes - one must refer to the portion of the stand alone code description b






32. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.






33. The lower anterior part of the bone






34. the bone is crushed and or shattered.






35. A medical record is documentation on the patient's social and medical history - family history - physical examination findings - progress notes - radiology and lab results - consultation reports and correspondence to patient.






36. A physician has a separate PPIN for each group office/clinic in which he or she practices. In the Medicare program - in addition to a group number - each member of a group is issued an 8-character performing provider identification number.






37. Is a group of two or more physicians and non-physician practitioners legally organized in a partnership - professional corporation - foundation - not-for-profit corporation - faculty practice plan - or similar association.






38. This is any procedure or service reported on the insurance claim that is not listed in the payer's master benefit list. This will result in the denial of the claim. Providers may be able to recover the charges from the patient.






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






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






41. requires investigation and needs further clarification.






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






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. 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






45. 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






46. This is any procedure or service reported on the insurance claim that is not listed in the payer's master benefit list. This will result in the denial of the claim. Providers may be able to recover the charges from the patient.






47. 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






48. 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.






49. The bones are connected to one another by fibrous bands of tissue . Muscles are attached to the bone by tendons. The fibrous covering of the muscles is called the fascia






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