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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. major skin pigment






2. death of tissue associated with loss of blood supply






3. This is any procedure or service reported on the insurance claim that is not listed in the payer's master benefit list. This will result in the denial of the claim. Providers may be able to recover the charges from the patient.






4. 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.






5. Absence of hair from areas where it normally grows






6. forms the roof of the nasal cavity.






7. make up part of the roof of the mouth






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






9. This is any procedure or service reported on the insurance claim that is not listed in the payer's master benefit list. This will result in the denial of the claim. Providers may be able to recover the charges from the patient.






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






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






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






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






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






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






16. 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.






17. A chronological account of the development of the complaint from the first sign or symptom that the patient experienced to the present






18. 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






19. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.






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






21. All patients have a right to privacy and all information should remain privileged. Discuss patient information only with the patient's physician or office personnel that need certain information to do their job. Obtain a signed consent form to releas






22. Is a working diagnosis which is not yet established.






23. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.






24. 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.






25. 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.






26. 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






27. The poisoning was self-inflicted.






28. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the






29. 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






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






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. 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.






33. 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.






34. Poisoning cannot be determined whether intentional or accidental.






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






36. 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.






37. 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.






38. Is a document provided to a Medicare beneficiary by a provider prior to service being rendered letting the beneficiary know of his/her responsibility to pay if Medicare denies the claim.






39. Was developed to promote the interests and well being of the patients and residents of the healthcare facility. This bill has still not become a law.


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






41. most synarthroses are immovable joints held together by fibrous tissue.






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






43. It is important that every patient seen by the physician has comprehensive legible documentation about the patient's illness - treatment and plans for the following reasons Avoidance of denied or delayed payments by insurance carriers investigating t






44. 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






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






46. 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.






47. This is located in the Index under the main term 'Neoplasm' and is organized by anatomic site. Each site has six columns with six possible codes determined by whether the neoplasm is malignant - benign - of uncertain behavior - or of unspecified natu






48. Is a managed care plan that gives beneficiaries the option whom to see for services. If the beneficiary goes to see a physician within the network - s/he will receive benefits similar to an HMO. But if the beneficiary chooses to see a physician from






49. 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






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