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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. This is the index for the E codes.It classifies - in alphabetical order - environmental events and other conditions as the cause of injury and other adverse effects.






2. This is used to indicate that the service provided was required by a third-party payer - governmental - legislative - or regulatory body. This does not include second opinion requested by a patient - family member - or another physician.






3. 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.






4. 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






5. Is defined as a doctor of medicine or osteopathy - dental medicine - dental surgery - podiatric medicine - optometry - or chiropractic medicine legally authorized to practice by the state in which he/she performs.






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






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






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






9. 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.






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






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






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






13. Poisoning cannot be determined whether intentional or accidental.






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






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






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






17. There are also terms indented two spaces to the right below the main term called subterms. These subterms are because they have bearing in the selection of the right code. Everything in the Index is listed by condition - that is - diagnosis - signs -






18. 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






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






20. 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






21. The bone is broken and pierces an internal organ






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






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






24. A minor fracture appears as a thin line on x-ray and may not extend completely through the bone.






25. Structural protein found in the skin and connective tissue






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






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






28. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.






29. 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






30. 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.






31. 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.






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






33. Under this schedule - a procedure's relative value is the sum total of three elements: Work: represents the amount of time - intensity of effort - and medical skill required of the physician. Overhead: practice costs related to the performing of the

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






35. The break of the distal end of the radius at the epiphysis often occurs when the patient has attempted to break his or her fall.






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






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






38. This is a set of information the physician gathers from the patient regarding the following:






39. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.






40. 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....






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






42. Is the federal government's health insurance program created by the Social Security Act of 1965 titled 'Health Insurance for the Aged and Disabled'. It is administered by the Centers for Medicare and Medicaid Services (CMS) - formerly known as Health






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






44. 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.






45. Small collection of clear fluid;blister






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






47. The reason the patient came to see the physician.






48. 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.






49. .. lower jaw bone.






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






Can you answer 50 questions in 15 minutes?



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