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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. 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






2. major skin pigment






3. Is the qualifying factor or factors that must be met before a patient receives benefits.






4. 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.






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






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






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






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






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






10. 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.






11. Bone that forms posterior/inferior part of the nasal septal wall between the nostrils.






12. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.






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






14. 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:






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






16. uncertain whether benign or malignant; borderline malignancy






17. The fractured area of bone collapses on itself.






18. - 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






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






20. 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).






21. 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.






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






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






24. This is the index for the E codes.It classifies - in alphabetical order - environmental events and other conditions as the cause of injury and other adverse effects.






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






26. 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.






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






28. death of tissue associated with loss of blood supply






29. This modifier is used to report a procedure or service that has more than one Modifier but the third-party payer does not allow the addition of multiple modifiers to the code. Modifier -99 is attached to the procedure code and the multiple Modifiers






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






31. make up part of the roof of the mouth






32. is referred to as Supplementary Medical Insurance (SMI). This coverage is a supplement to Part A - which covers medical expenses - clinical laboratory services - home health care - outpatient hospital treatment - blood - and ambulatory surgical serv






33. 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






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






35. 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






36. forms the back of the skull. There is a large hole at the ventral surface in this bone - called the foramen magnum - which allows the brain communication with the spinal cord






37. 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.






38. 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






39. Is the upper arm bone.






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






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






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






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






44. 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.






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






46. 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






47. 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






48. 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






49. 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 -






50. Law passed by the federal government to prosecute cases of Medicaid fraud.