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






2.






3. 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.






4. 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.






5. This is attached to the code of the E/M service provided to a patient during the postoperative period to indicate that that service is not part of the postoperative care which is usually part of a package of services of the surgery performed. Major s






6. forms the two lower sides of the cranium.






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






8. Describes the services billed and includes a breakdown of how the payment is determined






9. Cheekbone






10. 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.






11. Is defined as someone who has received medical services with in the last 3 years from the physician or another physician of the same specialty who belongs to the same group practice.






12. 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.






13. represents Exemption from the use of modifier -51






14. 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






15. Cheekbone






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






17. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)






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






19. A fat cell






20. Are composed of three-digit codes representing a single disease or condition.






21. 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






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






23. 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.






24. This is defined as incidents or practices - not usually considered fraudulent - that are inconsistent with the accepted medical business or fiscal practices in the industry. Examples of abuse are submitting a claim for a service or procedure performe






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






26. the bone is crushed and or shattered.






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






28. 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






29. Includes - but is not limited to - physician assistant - certified nurse-midwife - qualified psychologist - nurse practitioner - clinical social worker - physical therapist - occupational therapist - respiratory therapist - certified registered nurse






30. This is used to indicate that the service provided was required by a third-party payer - governmental - legislative - or regulatory body. This does not include second opinion requested by a patient - family member - or another physician.






31. 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






32. Contains complete - necessary information - but is incorrect or illogical in some way.






33. Small collection of clear fluid;blister






34. Forms the sides of the cranium






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






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






37. 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






38. Is a policy that covers losses to a third party caused by the insured - by an object owned by the insured - or on premises owned by the insured. Liability insurance claims are made to cover the cost of medical care for traumatic injuries - lost wages






39. Is a service performed by a physician whose opinion or advice is requested by another physician in the evaluation or treatment of a patient's illness or suspected problem. The consultant does not assume responsibility for the patient's care and must






40. male of household is primary payer






41. A physician has a separate PPIN for each group office/clinic in which he or she practices. In the Medicare program - in addition to a group number - each member of a group is issued an 8-character performing provider identification number.






42. '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






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






44. 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






45. 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






46. 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.






47. Lower portion of the pelvic bone






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






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






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