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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. the bone is crushed and or shattered.






2. Are small - rounded bones that resemble a sesame seed. They are found near joints and increase the efficiency of muscles near a joint. An example of sesamoid bone is the knee cap.






3. 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






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






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






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






7. '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






8. 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






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. The skin and its accessory organs.Integument means covering. The skin covers over an area of 22 square feet ( an average adult). It is a complex system of specialized tissues containing glands - nerves and blood vessels. The main function of the skin






11. Is a cumulative out-of-pocket amount that must be paid annually by the policyholder before benefits will be paid by the insurance company.






12. 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






13. Standard - fee-for-service - cost-sharing plan ; Extra - preferred provider organization ;Prime - health maintenance organization plan with a point-of-service option All of the above-mentioned plans covered under TRICARE - with the exception of Prime






14. 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.






15. 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






16. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.






17. Was created to provide medical benefits to spouses and children of veterans with total - permanent service related disabilities or for surviving spouses and children of a veteran who died as a result of service-related disability. It is a service ben






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






19. 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.






20. Represent services and procedures widely used by many health care professionals in clinical practice in multiple locations and have been approved by the FDA.






21. 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.


22. 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






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






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






25. 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.'






26. 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.






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






28. The bone is broken and pierces an internal organ






29. 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).






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






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






32. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.






33. 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.






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






35. This modifier is used to report a procedure or service that has more than one Modifier but the third-party payer does not allow the addition of multiple modifiers to the code. Modifier -99 is attached to the procedure code and the multiple Modifiers






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






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






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






39. An insurance plan issued to an individual. Premium rates are usually higher than group rates and service availability is lessened with this type of coverage.






40. 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






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






42. 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






43. This modifier is used to explain that the procedure or service done during a postoperative period was planned at the time of the original procedure. This is also used if a therapeutic procedure is performed because of the findings from a diagnostic p






44. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.






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






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






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






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






49. This modifier is used when: more than one procedure is performed during the same surgical episode; one code does not describe all of the procedures performed; and the secondary procedure is not minor or incidental to the major procedure. The followin






50. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.