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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. Is the upper arm bone.






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






3. Groove or crack like sore






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






5. 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.

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6. - 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.






7. 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






8. Typically not used on the claim form unless the provider does not have an EIN.






9. - 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






10. consists of 17 chapters based on either body system or cause or type of disease. The codes range from 001-999.






11. 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.






12. Further classified as to primary - secondary - or carcinoma in situ.






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






14. A medical record is documentation on the patient's social and medical history - family history - physical examination findings - progress notes - radiology and lab results - consultation reports and correspondence to patient.






15. Number assigned by the insurance company to a physician who renders services to patients.






16. 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






17. When a group of employees and their dependents are insured under one (1) group policy issued to the employer. Generally - the employer pays the premium or a portion of the premium and the employee pays the difference. This all depends on the type of






18. 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






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






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






21. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.






22. Number assigned to the physician by Medicare program.






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






24. 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.






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






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






27. 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






28. 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.






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






30. uncertain whether benign or malignant; borderline malignancy






31. The bone is broken and pierces an internal organ






32. 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.






33. Make up part of the interior of the nose.






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






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






36. Is a cost-sharing requirement for the insured to pay at the time of service. This amount is usually a specific dollar amount (e.g.. $15 - $20 - $25)






37. Discolored - flat lesion (freckles - tattoo marks)






38. Is defined by Medicare as 'the determination that a service or procedure rendered is reasonable and necessary for the diagnosis or treatment of an illness or injury.'






39. Number assigned to the physician by Medicare program.






40. A pregnant woman who has had at least one previous pregnancy.






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






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






43. Retention of medical records is governed by state and local laws and may vary from state-to-state. Most physicians are required to retain records indefinitely; deceased patient records should be kept for at least five (5) years.






44. 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






45. Is when two insurance companies work together to coordinate payment of the benefits.






46. Is a requirement for some health insurance plans to obtain permission for a service or procedure before it is done. It indicates that a specific procedure or service is deemed 'medically necessary'.






47. 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.






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






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






50. Noninvasive - non-spreading - nonmalignant







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