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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. 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






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






3. 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






4. The original cancer site. Malignant tumors are considered primary unless documented as secondary or metastatic.






5. means the provider agrees to accept what the insurance company approves as payment in full for the claim.






6. 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






7. 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






8. Deficient in pigment (melanin)






9. 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....






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






11. 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






12. A medical record is documentation on the patient's social and medical history - family history - physical examination findings - progress notes - radiology and lab results - consultation reports and correspondence to patient.






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






14. are small with irregular shapes. They are found in the wrist and ankle.






15. are composed of a group of three-digit categories representing a group of conditions or related conditions; they are divided into categories. e.g. . - Disorders of Thyroid Gland (240 - 246).






16. 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






17. Forms the sides of the cranium






18. Physicians agree to provide services at a discount of their usual fee in return for a pool of existing patients.






19. 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.






20. 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.






21. Structural protein found in the skin and connective tissue






22. Contains complete - necessary information - but is incorrect or illogical in some way.






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






24. open sore on the skin or mucous






25. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.






26. Are temporary codes for emerging technology - services and procedures. If a Category III code is available - it is reported instead of a Category I unlisted code.






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






28. 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.






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






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






31. 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






32. A fracture of the epiphyseal plate in children.






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






34. 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






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






36. Is an electronic or paper-based report of payment sent by the payer to the provider.






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






38. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).






39. 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






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






41. uncertain whether benign or malignant; borderline malignancy






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






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






44. 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






45. 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






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






47. Contains complete - necessary information - but is incorrect or illogical in some way.






48. Is the lower medial arm bone.






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






50. 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.