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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. 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.






2. anterior to the temporal bones.






3. 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






4. 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.






5. Is an electronic or paper-based report of payment sent by the payer to the provider.






6. 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.






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






8. 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.






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






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






11. Knowingly and intentionally deceiving or misrepresenting information that may result in unauthorized benefits is known as fraud.. Common forms of fraud are billing for services not furnished - unbundling - and misrepresenting diagnosis to justify pay






12. The bone is broken and pierces an internal organ






13. The CPT manual is composed of eight sections. Each section begins with guidelines that provide specific coding rules for that section. Guidelines at the beginning of the section are applicable to all codes in the section - while notes that pertain t






14. major skin pigment






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






16. Is a group of two or more physicians and non-physician practitioners legally organized in a partnership - professional corporation - foundation - not-for-profit corporation - faculty practice plan - or similar association.






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






18. 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 -






19. 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.






20. Federal law that prohibits submitting a fraudulent claim or making a false statement or representation in connection with a claim. It also protects and rewards persons involved in whistle-blower cases.






21. 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).






22. The cuticle at the lower part of the nail and this is sometimes referred to as the






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






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






25. Is a regionally managed healthcare program for active duty and retired members of the armed forces - their families - and survivors. It is a service benefit program and contains no premium. TRICARE is the new title for the CHAMPUS program (Civilian H






26. 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.






27. Is the upper arm bone.






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






29. 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.






30. 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.






31. Represents a new procedure or service code added since the previous edition of the manual.






32. 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.






33. A fracture of the epiphyseal plate in children.






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






35. Under capitation - the physician provides a full range of contracted services to covered patients for a fixed amount on a periodic basis. While guaranteed a fixed amount - the physician assumes the risk that the cost of providing the care to the pati






36. The CPT Index is arranged in alphabetical order by main terms which are further divided by subterms. There are five location methods: 1. Service or Procedure 2. Anatomic site 3. Condition or Disease 4. Synonym/Eponym 5. Abbreviation






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






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






39. death of tissue associated with loss of blood supply






40. 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






41. represents Exemption from the use of modifier -51






42. 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






43. The CPT manual is composed of eight sections. Each section begins with guidelines that provide specific coding rules for that section. Guidelines at the beginning of the section are applicable to all codes in the section - while notes that pertain t






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






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






46. Poisoning cannot be determined whether intentional or accidental.






47. Consist of codes found in the CPT manual. They are five position numeric codes used to report physician services rendered to patients






48. 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....






49. Are supplemental codes used for performance measurements. Although these codes are intended to facilitate data collection about the quality of care - their use is optional. Category II codes are published twice a year: January 1st and July 1st.






50. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.