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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. Are supplementary classification codes used to describe the reason or external cause of injury - poisoning and other adverse effects. These codes can be found in both Volumes I and II. E codes are used to classify environmental events - circumstances






2. This is used to indicate that the service provided was required by a third-party payer - governmental - legislative - or regulatory body. This does not include second opinion requested by a patient - family member - or another physician.






3. These parenthetic terms are called because their presence or absence does not have an effect on the selection of the code listed for the main term.






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






5. The bone is broken and pierces an internal organ






6. This is the inventory of the constitutional symptoms regarding the various body systems.






7. 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






8. 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.






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






10. 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.






11. - 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






12. 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






13. 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






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






15. is defined as reimbursement for income lost as a result of a temporary or permanent illness or injury. When patients are treated for disability diagnoses and other medical problems - separate patient records must be maintained. Disability insurance






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






17. 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






18. Noninvasive - non-spreading - nonmalignant






19. uncertain whether benign or malignant; borderline malignancy






20. Is a regionally managed healthcare program for active duty and retired members of the armed forces - their families - and survivors. It is a service benefit program and contains no premium. TRICARE is the new title for the CHAMPUS program (Civilian H






21. 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.






22. Deficient in pigment (melanin)






23. Small collection of clear fluid;blister






24. This modifier is used to indicate that the procedure or service provided during the postoperative period was not associated with the initial procedure. Payment for the full fee of the subsequent procedure is requested and a new global period starts.






25. Contains complete - necessary information - but is incorrect or illogical in some way.






26. - is a procedure or service provided without proper authorization or was not covered by a current authorization. The claim is denied and the provider cannot bill the patient for the charges.






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






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






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






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






31. This modifier is used to indicate that the procedure or service provided during the postoperative period was not associated with the initial procedure. Payment for the full fee of the subsequent procedure is requested and a new global period starts.






32. Medicaid is the payer of last resort. If the patient has Medicare and Medicaid - Medicaid usually pays for the Medicare Part B deductible - coinsurance - and monthly premium amounts. Some of the services covered by Medicaid include the following: Inp






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






34. The fractured area of bone collapses on itself.






35. Deficient in pigment (melanin)






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






37. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.






38. 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






39. Is the upper arm bone.






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






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






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






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






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






46. Cheekbone






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






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






49. death of tissue associated with loss of blood supply






50. A fracture of the epiphyseal plate in children.