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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. Is defined as a doctor of medicine or osteopathy - dental medicine - dental surgery - podiatric medicine - optometry - or chiropractic medicine legally authorized to practice by the state in which he/she performs.






2. Absence of hair from areas where it normally grows






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






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






5. 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






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






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






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






9. Under this schedule - a procedure's relative value is the sum total of three elements: Work: represents the amount of time - intensity of effort - and medical skill required of the physician. Overhead: practice costs related to the performing of the

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






12. Is one who has received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years....






13. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)






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






15. Any fracture occurring spontaneously as a result of disease.






16. Structural protein found in the skin and connective tissue






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






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






19. 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






20. 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.






21. Is a service performed by a physician whose opinion or advice is requested by another physician in the evaluation or treatment of a patient's illness or suspected problem. The consultant does not assume responsibility for the patient's care and must






22. Is defined as someone who has received medical services with in the last 3 years from the physician or another physician of the same specialty who belongs to the same group practice.






23. 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






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






25. Is a percentage of the cost of covered services that a policyholder or a secondary insurance pays. A common payment percentage for coinsurance is 80/20 which indicates that 20% is the coinsurance for which the beneficiary or secondary insurance is re






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






27. The poisoning was self-inflicted.






28. Are conditions - situations - and services not covered by the insurance carrier.






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






30. Are small - rounded bones that resemble a sesame seed. They are found near joints and increase the efficiency of muscles near a joint. An example of sesamoid bone is the knee cap.






31. 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.






32. Physicians agree to provide services at a discount of their usual fee in return for a pool of existing patients.






33. 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






34. Benign growth extending from the surface of the mucous membrane






35. 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






36. 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






37. Cheekbone






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. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body






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






41. forms the two lower sides of the cranium.






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






43. 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






44. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.






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






46. This is defined as incidents or practices - not usually considered fraudulent - that are inconsistent with the accepted medical business or fiscal practices in the industry. Examples of abuse are submitting a claim for a service or procedure performe






47. 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..






48. 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.






49. male of household is primary payer






50. Small collection of clear fluid;blister







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