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Medical Billing And Coding Vocab

Instructions:
  • Answer 50 questions in 15 minutes.
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  • Match each statement with the correct term.
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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. Groove or crack like sore






2. Physicians are legally responsible for their own conduct and any actions of their employees (their designee) performed within the context of their employment. This is referred to as 'vicarious liability -' also known as 'respondent superior -' which






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






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






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






6. Is when two insurance companies work together to coordinate payment of the benefits.






7. 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






8. numbers 8-10 - are attached to the sternum by cartilage






9. 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.






10. The fractured area of bone collapses on itself.






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






12. Most procedures have both professional (physician) and technical components. This modifier is attached to the procedure to indicate that the physician provided only the professional component.






13. the bone is crushed and or shattered.






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






15. 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






16. 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






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






18. Are supplementary classification codes used to describe the reason or external cause of injury - poisoning and other adverse effects. These codes can be found in both Volumes I and II. E codes are used to classify environmental events - circumstances






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






20. 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.






21. Also called 'global surgery' - includes a variety of services rendered by a surgeon which includes the following: Surgical procedure performed Local infiltration - metacarpal/metatarsal/digital block - or topical anesthesia Preoperative E/M services






22. paired bones at the corner of each eye that cradle the tear ducts.






23. 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..






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






25. 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.






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






27. cancer that is localized and has not spread to adjacent tissues or distant parts of the body






28. The poisoning was self-inflicted.






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






30. 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.






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






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






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






34. Is a regionally managed healthcare program for active duty and retired members of the armed forces - their families - and survivors. It is a service benefit program and contains no premium. TRICARE is the new title for the CHAMPUS program (Civilian H






35. Prescription Drugs The Medicare Prescription Drug - Improvement - and Modernization Act enacted in December 2003 and began implementation in January 2006 where Medicare beneficiaries can enroll in the Medicare prescription drug plan. The beneficiari






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






37. It is important that every patient seen by the physician has comprehensive legible documentation about the patient's illness - treatment and plans for the following reasons Avoidance of denied or delayed payments by insurance carriers investigating t






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






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






40. The plan of the parent whose birthday falls earlier in the year (month and day - not year) is primary to that whose birthday falls later in the year. If both parents have the same birthday - then the plan of the parent who has had the longest coverag






41. is basically the same as HMO in the sense that the health care provider enters into contract with the MCOs to render services to the beneficiaries. However - PPO's charge a higher premium than HMO's in exchange for more flexibility and more options






42. is defined as reimbursement for income lost as a result of a temporary or permanent illness or injury. When patients are treated for disability diagnoses and other medical problems - separate patient records must be maintained. Disability insurance






43. forms the two lower sides of the cranium.






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






45. 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






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






47. 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






48. 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.






49. male of household is primary payer






50. Forms the sides of the cranium







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