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






2. 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






3. Are the finger bones. Each finger has three phalanges - except for the thumb. The three phalanges are the proximal - middle and a distal phalanx. The thumb has a proximal and distal.






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






5. is referred to as Supplementary Medical Insurance (SMI). This coverage is a supplement to Part A - which covers medical expenses - clinical laboratory services - home health care - outpatient hospital treatment - blood - and ambulatory surgical serv






6. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.






7. 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.






8. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.






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






10. This is an alternative to paper claims submitted to the third-party payer directly by the physician or through a clearinghouse. Electronic claims are usually paid faster than paper claims and most electronic claims software have self-editing features






11. 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






12. - 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.






13. These parenthetic terms are called because their presence or absence does not have an effect on the selection of the code listed for the main term.






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






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






16. 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






17. 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






18. Is the upper arm bone.






19. This consists of the patient's personal experiences with illnesses - surgeries and injuries. It also contains information of illnesses predominant in the family. It contains the patient's educational background - occupation - marital status - and oth






20. anterior to the temporal bones.






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






22.






23. 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).






24. Number assigned to the physician by Medicare program.






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






26. Cheekbone






27. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.






28. Poisoning cannot be determined whether intentional or accidental.






29. uncertain whether benign or malignant; borderline malignancy






30. 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






31. 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....






32. 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






33. open sore on the skin or mucous






34. 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






35. Poisoning cannot be determined whether intentional or accidental.






36. 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






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






38. solid - round or oval elevated lesion more than 1 cm in diameter






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






40. .. lower jaw bone.






41. 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






42. 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.






43. Smooth - slightly elevated - edematous(swollen) area that is redder or paler than the surrounding skin.






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






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






46. Absence of hair from areas where it normally grows






47. An insurance plan issued to an individual. Premium rates are usually higher than group rates and service availability is lessened with this type of coverage.






48. 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).






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






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