Test your basic knowledge |

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. Small collection of clear fluid;blister






2. Under capitation - the physician provides a full range of contracted services to covered patients for a fixed amount on a periodic basis. While guaranteed a fixed amount - the physician assumes the risk that the cost of providing the care to the pati






3. The break of the distal end of the radius at the epiphysis often occurs when the patient has attempted to break his or her fall.






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






5. They are for profit organizations that operate in the private sector selling different health insurance benefits plans to groups or individuals. Most commercial plans have predefined patient yearly deductibles and coinsurance generally based on 80/2






6. 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






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






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






9. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.






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






11. Consists of the skull - rib cage - and spine






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






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






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. The CPT Index is arranged in alphabetical order by main terms which are further divided by subterms. There are five location methods: 1. Service or Procedure 2. Anatomic site 3. Condition or Disease 4. Synonym/Eponym 5. Abbreviation






16. Various terms are used to describe the state of submitted forms. The following are some of the terms that are typically used by insurance carriers.






17. Created the Health Care Fraud and Abuse Control Program enacted to check for fraud and abuse in the Medicare and Medicaid programs - and private payers.






18. 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






19. - 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.






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






21. 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






22. The moon like white area at the base of the nail.






23. 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.






24. The poisoning was self-inflicted.






25. HCPCS Reference Manual The CMS assigns a standard unique identifier known as the National Provider Identifier (NPI) The CMS also developed a two-part coding system called the Healthcare Common Procedure Coding System ( HCPCS ) which is a collection o






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






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






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






29. Cheekbone






30. 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






31. 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.






32. Eccrine sweat glands are the most common and the apocrine sweat glands that secrete an odorless sweat.






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






34. open sore on the skin or mucous






35. 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






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






37. 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.






38. 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






39. 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.






40. Most billing-related cases are based on HIPAA and False Claims Act.






41. Structural protein found in the skin and connective tissue






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






43. Is a term used when a patient is admitted to the hospital with the expectation that the patient will stay for a period of 24 hours or more.






44. 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.






45. 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

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


46. means the provider agrees to accept what the insurance company approves as payment in full for the claim.






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






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






49. 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






50. 'Errors and omissions insurance' is protection against loss of monies caused by failure through error or unintentional omission on the part of the individual or service submitting the insurance claim. Some physicians' contract with a billing service