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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. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.






2. Are typically very strong - are broad at the ends and have large surfaces for muscle attachment.






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






4. 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






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






6. 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






7. The bone is partially bent and partially broken; this is a common fracture in children because their bones are still soft.






8. Federal law that prohibits submitting a fraudulent claim or making a false statement or representation in connection with a claim. It also protects and rewards persons involved in whistle-blower cases.






9. 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.






10. Forms the sides of the cranium






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






12. This involves the use of relative value scales which assign a relative weight to individual services according to the basis for the scale. Services that are more difficult - time consuming - or resource intensive to perform typically have higher rela






13. Structural protein found in the skin and connective tissue






14. 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).






15. The fractured area of bone collapses on itself.






16. Are small - rounded bones that resemble a sesame seed. They are found near joints and increase the efficiency of muscles near a joint. An example of sesamoid bone is the knee cap.






17. Has all required fields accurately filled out - contains no deficiencies and passes all edits. The carrier does not require investigation outside of the carrier's operation before paying the claim.






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






19. forms the back of the skull. There is a large hole at the ventral surface in this bone - called the foramen magnum - which allows the brain communication with the spinal cord






20. Are the main division in the ICD-9-CM; they are divided into sections. e.g.. - 3. Endocrine - Nutritional and Metabolic Diseases - and Immunity Disorders (240-279).






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






22. 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






23. 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.






24. 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.






25. 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.






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






27. most synarthroses are immovable joints held together by fibrous tissue.






28. Number assigned to the physician by Medicare program.






29. Is the lower medial arm bone.






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






31. The bone is broken and pierces an internal organ






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






33. 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






34. 'Errors and omissions insurance' is protection against loss of monies caused by failure through error or unintentional omission on the part of the individual or service submitting the insurance claim. Some physicians' contract with a billing service






35. is a federal program administered by state governments to provide medical assistance to the needy. Each state sets its own guidelines for eligibility and services - therefore benefits and coverage may vary widely from state to state.






36. Is a fee that is charged for each procedure or service performed by the physician. This fee is obtained from a fee schedule - which is a list of charges or allowance that have accepted for specific medical services. The system in which fee schedules






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






38. 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.






39. 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






40. Medicare Managed Care Plans (Formerly Medicare Plus (+) Choice Plan) was created to offer a number of healthcare services in addition to those available under Part A and Part B. The CMS contracts with managed care plans or provider service organizati






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






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






43. The moon like white area at the base of the nail.






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






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






46. Is a group of two or more physicians and non-physician practitioners legally organized in a partnership - professional corporation - foundation - not-for-profit corporation - faculty practice plan - or similar association.






47. open sore on the skin or mucous






48. male of household is primary payer






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






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