Test your basic knowledge |

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






2. Groove or crack like sore






3. 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






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






5. Codes from the CPT codebook are used to report services and procedures by physicians. It is published and updated annually by the American Medical Association (AMA) with a new one coming out each November and becoming effective on January 1st of the






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






7. the bone is crushed and or shattered.






8. Indicates add-on codes






9. Provide a four-digit code (one digit after the decimal point) which is more specific than category code (3-digit) in terms of cause - site - or manifestation of the condition. This must be used if available. From subcategory - specificity moves to an






10. Small collection of clear fluid;blister






11. Is the upper arm bone.






12. death of tissue associated with loss of blood supply






13. 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.






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






15. Developed by the CMS to promote national correct coding methodologies and to control improper coding that leads to inappropriate payment of Part B health insurance claims.






16. Are the main division in the ICD-9-CM; they are divided into sections. e.g.. - 3. Endocrine - Nutritional and Metabolic Diseases - and Immunity Disorders (240-279).






17. 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.






18. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.






19. Poisoning cannot be determined whether intentional or accidental.






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






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






22. Is the type of plan a patient may have where they can see providers outside their plan. The patient is responsible to pay the higher portion of the fee.






23. Is the type of plan a patient may have where they can see providers outside their plan. The patient is responsible to pay the higher portion of the fee.






24. 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).






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






26. poisoning was inflicted by another person with intent to kill or injure






27. means the provider agrees to accept what the insurance company approves as payment in full for the claim.






28. .. lower jaw bone.






29. Numbers 1-7 - attach directly to the sternum in the front of the body.






30. Upper jaw bone






31. Created the Health Care Fraud and Abuse Control Program enacted to check for fraud and abuse in the Medicare and Medicaid programs - and private payers.






32. the bone is broken and the ends are driven into each other.






33. Is the lateral lower arm bone (in line with the thumb).






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






35. Deficient in pigment (melanin)






36. 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.






37. requires investigation and needs further clarification.






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






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






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






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






42. 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.






43. 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






44. represents Exemption from the use of modifier -51






45. 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.






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. To report a circumstance in which the physician returns to the operating room to address a complication stemming from the initial procedure - modifier -78 is attached to the subsequent procedure code.






48. Developed by the CMS to promote national correct coding methodologies and to control improper coding that leads to inappropriate payment of Part B health insurance claims.






49. 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






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