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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 a managed care benefits plan that provides a wide range of medical services to individuals that have been enrolled into the program. It is generally the least costly but at the same time also the most restrictive. This plan uses a gatekeeper physi






2. Poisoning cannot be determined whether intentional or accidental.






3. Cheekbone






4. is one who has not received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years.






5. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called






6. 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






7. The musculoskeletal system includes the bones - muscles - and joints The musculoskeletal system acts as a framework for the organs - protects many of those organs - and also provides the organism the ability to move..






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






9. 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






10. Consists of the skull - rib cage - and spine






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






12. 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.






13. The epidermis - the dermis - and the subcutaneous layer. The epidermis is a thin - cellular membrane layer that contains keratin. The dermis is a dense - fibrous - connective tissue that contains collagen. The subcutaneous layer is a thicker and fatt






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






15. Small collection of clear fluid;blister






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






17. 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.






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






19. Various terms are used to describe the state of submitted forms. The following are some of the terms that are typically used by insurance carriers.






20. Are wrist bones. There are 2 rows of four bones in the wrist. The metacarpals are the five radiating bones in the fingers. These are the bones in the palm of the hand.






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






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






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






24. The lower anterior part of the bone






25. 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






26. .. lower jaw bone.






27. Upper jaw bone






28. Law passed by the federal government to prosecute cases of Medicaid fraud.






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






30. 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....






31. contains errors or omissions. Usually - these claims do not pass front-end edits. They are either processed manually for resolving problems - or rejected for payment.






32. male of household is primary payer






33. Is to determine the patient's benefits and the maximum dollar amount that the insurance company will pay. Often the first step of the insurance verification process - it is completed prior to the first visit.






34. 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.






35. 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'.






36. Families - pregnant women - and children ;Aid to Families with Dependent Children (AFDC)-related groups ;Non-AFDC pregnant women and children;Aged and disabled persons ;Supplemental Security Income (SSI)-related groups ;Qualified Medicare Beneficiari






37. Are supplementary classification codes used to identify health care encounters that occur for reasons other than illness or injury or to identify patients whose illness is influenced by special circumstances or problems. The codes can be found in bot






38. Is one who has no contract with the health insurance plan.






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






40. 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






41. 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.






42. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.






43. 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






44. Number assigned to the physician by Medicare program.






45. 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






46. These parenthetic terms are called because their presence or absence does not have an effect on the selection of the code listed for the main term.






47. Consists of the skull - rib cage - and spine






48. Law passed by the federal government to prosecute cases of Medicaid fraud.






49. A fat cell






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