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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. Benign growth extending from the surface of the mucous membrane






2. Number assigned to the physician by Medicare program.






3. 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.






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






5. Medicaid is the payer of last resort. If the patient has Medicare and Medicaid - Medicaid usually pays for the Medicare Part B deductible - coinsurance - and monthly premium amounts. Some of the services covered by Medicaid include the following: Inp






6. Poisoning was due to: Accidental overdose; Wrong substance taken; Accidents in use of drugs and biologicals; External causes of poisonings classifiable to 980-989 Therapeutic Use: instances when a correct substance properly taken is the cause of adve






7. 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.






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






9. Numbers 1-7 - attach directly to the sternum in the front of the body.






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






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






12. An accelerated - severe form of hypertension with vascular damage and a diastolic pressure of 130mmHg or greater.






13. Is defined as someone who has received medical services with in the last 3 years from the physician or another physician of the same specialty who belongs to the same group practice.






14. 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






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






16. Superior and widest bone






17. 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.






18. 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






19. Is a statement of the patient's account history - showing dates of service - detailed charges - payments (i.e. deductibles and co-pays) - the date the insurance claim was submitted - applicable adjustments and account balance.






20. 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.






21. This is defined as incidents or practices - not usually considered fraudulent - that are inconsistent with the accepted medical business or fiscal practices in the industry. Examples of abuse are submitting a claim for a service or procedure performe






22. 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.






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






24. The bones are connected to one another by fibrous bands of tissue . Muscles are attached to the bone by tendons. The fibrous covering of the muscles is called the fascia






25. represents Exemption from the use of modifier -51






26. death of tissue associated with loss of blood supply






27. 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.






28. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)






29. Poisoning was due to: Accidental overdose; Wrong substance taken; Accidents in use of drugs and biologicals; External causes of poisonings classifiable to 980-989 Therapeutic Use: instances when a correct substance properly taken is the cause of adve






30. 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.






31. The reason the patient came to see the physician.






32. 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






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






34.






35. The reason the patient came to see the physician.






36. 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






37. A fracture of the epiphyseal plate in children.






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






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






40. Cheekbone






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






42. The physician must obtain this number in order to practice within a state.






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






44. Consists of the skull - rib cage - and spine






45. Is a requirement for some health insurance plans to obtain permission for a service or procedure before it is done. It indicates that a specific procedure or service is deemed 'medically necessary'.






46. Is an entity that receives transmissions of claims from physicians' offices - separates the claims by carriers and performs software edits on each claim to check for errors. Once this process is complete - the claim is then sent to the proper insuran






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






48. male of household is primary payer






49. Under capitation - the physician provides a full range of contracted services to covered patients for a fixed amount on a periodic basis. While guaranteed a fixed amount - the physician assumes the risk that the cost of providing the care to the pati






50. 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).