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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. Represents a new procedure or service code added since the previous edition of the manual.






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






3. Is a fee that is charged for each procedure or service performed by the physician. This fee is obtained from a fee schedule - which is a list of charges or allowance that have accepted for specific medical services. The system in which fee schedules






4. Are a group of independently licensed local companies - usually nonprofit that contracts with physicians and other health entities to provide services to their insured companies and individuals. Most BC/BS plans offer HMO's - PPO's and POS plans. Blu






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






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






7. 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






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






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






10. 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.






11. death of tissue associated with loss of blood supply






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






13. This is the traditional method used by providers for submission of charges to insurance companies. The most commonly used form is the CMS-1500. Few plans still accept the physician's encounter form or superbill and Medicare will only accept claims on






14. 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






15. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.






16. This is not specified as benign or malignant in the diagnosis or medical record.






17. Are the finger bones. Each finger has three phalanges - except for the thumb. The three phalanges are the proximal - middle and a distal phalanx. The thumb has a proximal and distal.






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






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






20. 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






21. Is the federal government's health insurance program created by the Social Security Act of 1965 titled 'Health Insurance for the Aged and Disabled'. It is administered by the Centers for Medicare and Medicaid Services (CMS) - formerly known as Health






22. Absence of hair from areas where it normally grows






23. 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.






24. Upper jaw bone






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






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






27. 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.






28. This is an alternative to paper claims submitted to the third-party payer directly by the physician or through a clearinghouse. Electronic claims are usually paid faster than paper claims and most electronic claims software have self-editing features






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






30. Also known as Federal tax identification number. This is issued by the Internal Revenue Service






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






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






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






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






35. Forms the sides of the cranium






36. 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.






37. Are codes formulated thru the joint efforts of the CMS - the Health Insurance Association of America - and the Blue Cross and Blue Shield Association. Level II contains five position alpha-numeric codes for physician and non-physician services not fo






38. major skin pigment






39. A fat cell






40. Mild or controlled hypertension and no damage to the vascular system or organs.






41. Small collection of clear fluid;blister






42. Is a fee that is charged for each procedure or service performed by the physician. This fee is obtained from a fee schedule - which is a list of charges or allowance that have accepted for specific medical services. The system in which fee schedules






43. 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






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






45. 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.






46. 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.






47. 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.






48. The reason the patient came to see the physician.






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






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