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






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






4. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body






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






6. major skin pigment






7. 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 -






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






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






10. 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






11. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.






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. Is a patient who receives treatment in any of the following settings: physician's office ;hospital clinic - emergency department - hospital same-day surgery unit - ambulatory surgical center ( patient is released within 23 hours) ;hospital admission






14. This number is used instead of the individual physician's number for the performing provider who is a member of a group practice that submits claims to insurance companies under the group name.






15. Is one who has no contract with the health insurance plan.






16. The bones are connected to one another by fibrous bands of tissue . Muscles are attached to the bone by tendons. The fibrous covering of the muscles is called the fascia






17. Physicians agree to provide services at a discount of their usual fee in return for a pool of existing patients.






18. Number assigned to the physician by Medicare program.






19. Pre-determined set of benefits covered under one set annual fee.






20. Poisoning cannot be determined whether intentional or accidental.






21. 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.






22. The epidermis - the dermis - and the subcutaneous layer. The epidermis is a thin - cellular membrane layer that contains keratin. The dermis is a dense - fibrous - connective tissue that contains collagen. The subcutaneous layer is a thicker and fatt






23. 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






24. 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






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






26. 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.






27. Is one who has received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years....






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






29. 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






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






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






32. 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






33. 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






34. 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.






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






36. major skin pigment






37. The plan of the parent whose birthday falls earlier in the year (month and day - not year) is primary to that whose birthday falls later in the year. If both parents have the same birthday - then the plan of the parent who has had the longest coverag






38. Forms the anterior part of the skull and the forehead






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






40. The musculoskeletal system includes the bones - muscles - and joints The musculoskeletal system acts as a framework for the organs - protects many of those organs - and also provides the organism the ability to move..






41. 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






42. Standard - fee-for-service - cost-sharing plan ; Extra - preferred provider organization ;Prime - health maintenance organization plan with a point-of-service option All of the above-mentioned plans covered under TRICARE - with the exception of Prime






43. 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






44. 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.






45. 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.






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






47. Is one who has no contract with the health insurance plan.






48. Physicians are legally responsible for their own conduct and any actions of their employees (their designee) performed within the context of their employment. This is referred to as 'vicarious liability -' also known as 'respondent superior -' which






49. - 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.






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