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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. found in the Index under the main term 'Hypertension' - and it contains a list of conditions that are due to or associated with hypertension. The table classifies the conditions as:






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






3. 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 -






4. Number assigned to the physician by Medicare program.






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






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






7. Are temporary codes for emerging technology - services and procedures. If a Category III code is available - it is reported instead of a Category I unlisted code.






8. Was created to provide medical benefits to spouses and children of veterans with total - permanent service related disabilities or for surviving spouses and children of a veteran who died as a result of service-related disability. It is a service ben






9. Are wrist bones. There are 2 rows of four bones in the wrist. The metacarpals are the five radiating bones in the fingers. These are the bones in the palm of the hand.






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






11. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients






12. found in the Index under the main term 'Hypertension' - and it contains a list of conditions that are due to or associated with hypertension. The table classifies the conditions as:






13. 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






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






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






16. 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






17. 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.






18. This consists of the patient's personal experiences with illnesses - surgeries and injuries. It also contains information of illnesses predominant in the family. It contains the patient's educational background - occupation - marital status - and oth






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






20. Is a statement of the patient's account history - showing dates of service - detailed charges - payments (i.e. deductibles and co-pays) - the date the insurance claim was submitted - applicable adjustments and account balance.






21. 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






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






23. 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






24. Represent changes in the text or definition between the triangles.






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






26. 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






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






28. 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.






29. 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






30. open sore on the skin or mucous






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. are small with irregular shapes. They are found in the wrist and ankle.






33. 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






34. 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.






35. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients






36. 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).






37. Was developed to promote the interests and well being of the patients and residents of the healthcare facility. This bill has still not become a law.

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38. All patients have a right to privacy and all information should remain privileged. Discuss patient information only with the patient's physician or office personnel that need certain information to do their job. Obtain a signed consent form to releas






39. Is an electronic or paper-based report of payment sent by the payer to the provider.






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






41. Has all required fields accurately filled out - contains no deficiencies and passes all edits. The carrier does not require investigation outside of the carrier's operation before paying the claim.






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






43. 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.






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






45. 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.






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






47. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.






48. Number assigned by the insurance company to a physician who renders services to patients.






49. 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






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







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