Test your basic knowledge |

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 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.






2. Developed by the CMS to promote national correct coding methodologies and to control improper coding that leads to inappropriate payment of Part B health insurance claims.






3. 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






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






5. forms the two lower sides of the cranium.






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






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






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






9. Indicates add-on codes






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






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






12. is defined as one who has not received any medical services within the last three years.






13. The E&M section includes codes that pertain to the nature of the physicians' work. The codes depend on type of service - patient status - and place where service was rendered. The E&M section is divided into broad categories such as office visits - h






14. 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






15. 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






16. Is a working diagnosis which is not yet established.






17. 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'.






18. A fat cell






19. '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






20. A physician has a separate PPIN for each group office/clinic in which he or she practices. In the Medicare program - in addition to a group number - each member of a group is issued an 8-character performing provider identification number.






21. 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






22. 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






23. Unlike the RBRVS - the RVP has no geographic adjustment factor or individual RVU component to calculate. However - for each category of procedures - a separate conversion factor must be developed....






24. 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






25. 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.






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






27. forms the two lower sides of the cranium.






28. 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






29. Are composed of three-digit codes representing a single disease or condition.






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






31. the bone is crushed and or shattered.






32. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.






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






34. 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.


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






36. Is a term used when a patient is admitted to the hospital with the expectation that the patient will stay for a period of 24 hours or more.






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






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






39. 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.






40. Is the upper arm bone.






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






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






43. The main term in the index may by followed by terms within parenthesis.






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






45. 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






46. open sore on the skin or mucous






47. The moon like white area at the base of the nail.






48. Cheekbone






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






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