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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. There are also terms indented two spaces to the right below the main term called subterms. These subterms are because they have bearing in the selection of the right code. Everything in the Index is listed by condition - that is - diagnosis - signs -






2. Upper jaw bone






3. 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






4. Further classified as to primary - secondary - or carcinoma in situ.






5. 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






6. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.






7. 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






8. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.






9. most synarthroses are immovable joints held together by fibrous tissue.






10. 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






11. A chronological account of the development of the complaint from the first sign or symptom that the patient experienced to the present






12. Are the main division in the ICD-9-CM; they are divided into sections. e.g.. - 3. Endocrine - Nutritional and Metabolic Diseases - and Immunity Disorders (240-279).






13. Indicates add-on codes






14. 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






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






16. Is a managed care plan that gives beneficiaries the option whom to see for services. If the beneficiary goes to see a physician within the network - s/he will receive benefits similar to an HMO. But if the beneficiary chooses to see a physician from






17. 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






18. Most procedures have both professional (physician) and technical components. This modifier is attached to the procedure to indicate that the physician provided only the professional component.






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






20. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.






21. The poisoning was self-inflicted.






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






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






24. 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.






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






26. Also called 'global surgery' - includes a variety of services rendered by a surgeon which includes the following: Surgical procedure performed Local infiltration - metacarpal/metatarsal/digital block - or topical anesthesia Preoperative E/M services






27. Cheekbone






28. The plan of the parent whose birthday falls earlier in the year (month and day - not year) is primary to that whose birthday falls later in the year. If both parents have the same birthday - then the plan of the parent who has had the longest coverag






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






30. The poisoning was self-inflicted.






31. Forms the sides of the cranium






32. 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.






33. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.






34. Is defined by Medicare as 'the determination that a service or procedure rendered is reasonable and necessary for the diagnosis or treatment of an illness or injury.'






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






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






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






38. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.






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






40. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.






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






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






43. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.






44. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.






45. death of tissue associated with loss of blood supply






46. Upper jaw bone






47. The lower anterior part of the bone






48. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the






49. Is the lower medial arm bone.






50. This number is used instead of the individual physician's number for the performing provider who is a member of a group practice that submits claims to insurance companies under the group name.