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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. - 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






2. 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.






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






4. 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 -






5. Small collection of clear fluid;blister






6. 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.






7. Structural protein found in the skin and connective tissue






8. 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






9. Deficient in pigment (melanin)






10. Retention of medical records is governed by state and local laws and may vary from state-to-state. Most physicians are required to retain records indefinitely; deceased patient records should be kept for at least five (5) years.






11. 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.






12. 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.






13. 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






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






15. 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






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






17. 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






18. Is the type of plan a patient may have where they can see providers outside their plan. The patient is responsible to pay the higher portion of the fee.






19. 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






20. 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 -






21. Is the lower medial arm bone.






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. Mild or controlled hypertension and no damage to the vascular system or organs.






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






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






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






27. forms the two lower sides of the cranium.






28. A fat cell






29. 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






30. 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






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






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






33. - is a procedure or service provided without proper authorization or was not covered by a current authorization. The claim is denied and the provider cannot bill the patient for the charges.






34. 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






35. Provide the means by which the reporting physician can indicate that a service or procedure that has been performed has been altered by some specific circumstance but not changed in its definition or code.






36. is a traumatic injury to a joint involving the soft tissue.






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






38. 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.






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






40. This is also known as fee-for-service. Under this plan - the services that are paid for are listed in the policy and payments are based on the fees physicians charge for the service. Each year - the beneficiary must meet a deductible - after which -






41. 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.






42. Is the upper arm bone.






43. 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.






44. death of tissue associated with loss of blood supply






45. Provide a four-digit code (one digit after the decimal point) which is more specific than category code (3-digit) in terms of cause - site - or manifestation of the condition. This must be used if available. From subcategory - specificity moves to an






46. 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






47. Small collection of clear fluid;blister






48. 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






49. Produce secretions that allow the body to be moisturized or cooled.






50. Make up part of the interior of the nose.