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






2. Are located in the dermal layer of the skin over the entire body - except for the palms of the hands and soles of the feet. The sebaceous glands secrete an oily substance called sebum. Sebum contains lipids that help lubricate the skin and minimize w






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






4. 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






5. Are conditions - situations - and services not covered by the insurance carrier.






6. 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.






7. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)






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






9. 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






10. 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






11. This is defined as incidents or practices - not usually considered fraudulent - that are inconsistent with the accepted medical business or fiscal practices in the industry. Examples of abuse are submitting a claim for a service or procedure performe






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






13. This modifier is used when the same procedure is performed on a mirror-image part of the body..






14. Number assigned to the physician by Medicare program.






15. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)






16. 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






17. This modifier is used when the same procedure is performed on a mirror-image part of the body..






18. Used for procedures that is always performed during the same operative session as another surgery in addition to the primary service/procedure and is never performed separately.






19. Pre-determined set of benefits covered under one set annual fee.






20. 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






21. This modifier is used to indicate that the procedure or service provided during the postoperative period was not associated with the initial procedure. Payment for the full fee of the subsequent procedure is requested and a new global period starts.






22. 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.






23. 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






24. Benign growth extending from the surface of the mucous membrane






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






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






27. 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.






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






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






30. 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






31. 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






32. Indicates add-on codes






33. 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






34. Number assigned to the physician by Medicare program.






35. Deficient in pigment (melanin)






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. 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






38. Is the cost of insurance coverage paid annually - semi-annually or monthly to keep a policy in effect.






39. The poisoning was self-inflicted.






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






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






42. Is a patient who receives treatment in any of the following settings: physician's office ;hospital clinic - emergency department - hospital same-day surgery unit - ambulatory surgical center ( patient is released within 23 hours) ;hospital admission






43. represents Exemption from the use of modifier -51






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






45. forms the back of the skull. There is a large hole at the ventral surface in this bone - called the foramen magnum - which allows the brain communication with the spinal cord






46. The spinal /vertebral column is divided into five regions from the neck to the tailbone. There are 26 bones in the spine and they are referred to as the vertebrae. The following list explains the bones of the spine: Cervical -Neck Bones -Thoracic -U






47. 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.






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






49. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.






50. .. lower jaw bone.