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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. Standard - fee-for-service - cost-sharing plan ; Extra - preferred provider organization ;Prime - health maintenance organization plan with a point-of-service option All of the above-mentioned plans covered under TRICARE - with the exception of Prime






2. death of tissue associated with loss of blood supply






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






4. represents Exemption from the use of modifier -51






5. A fat cell






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






7. Cancer that has metastasized (spread) to a secondary site either adjacent or remote region of the body






8. 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....






9. Is the federal government's health insurance program created by the Social Security Act of 1965 titled 'Health Insurance for the Aged and Disabled'. It is administered by the Centers for Medicare and Medicaid Services (CMS) - formerly known as Health






10. Number assigned to the physician by Medicare program.






11. 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.






12. Retention of medical records is governed by state and local laws and may vary from state-to-state. Most physicians are required to retain records indefinitely; deceased patient records should be kept for at least five (5) years.






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






14. 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






15. 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.






16. The bone is broken and pierces an internal organ






17. Noninvasive - non-spreading - nonmalignant






18. Was developed to promote the interests and well being of the patients and residents of the healthcare facility. This bill has still not become a law.

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19. The lower anterior part of the bone






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






21. Considered experimental - newly approved - or seldom used may not be listed in the CPT manual. These codes can be coded as unlisted procedures. They are located at the end of the subsections or subheadings. When an unlisted procedure code is reported






22. 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....






23. 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.






24. Is a managed care plan that gives beneficiaries the option whom to see for services. If the beneficiary goes to see a physician within the network - s/he will receive benefits similar to an HMO. But if the beneficiary chooses to see a physician from






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






26. Knowingly and intentionally deceiving or misrepresenting information that may result in unauthorized benefits is known as fraud.. Common forms of fraud are billing for services not furnished - unbundling - and misrepresenting diagnosis to justify pay






27. the bone is crushed and or shattered.






28. 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






29. Poisoning cannot be determined whether intentional or accidental.






30. This is also known as fee-for-service. Under this plan - the services that are paid for are listed in the policy and payments are based on the fees physicians charge for the service. Each year - the beneficiary must meet a deductible - after which -






31. Describes the services billed and includes a breakdown of how the payment is determined






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






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






34. 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






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






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






37. Considered experimental - newly approved - or seldom used may not be listed in the CPT manual. These codes can be coded as unlisted procedures. They are located at the end of the subsections or subheadings. When an unlisted procedure code is reported






38. make up part of the roof of the mouth






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






40. Is a term used when a patient is admitted to the hospital with the expectation that the patient will stay for a period of 24 hours or more.






41. This is attached to the code of the E/M service provided to a patient during the postoperative period to indicate that that service is not part of the postoperative care which is usually part of a package of services of the surgery performed. Major s






42. 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






43. Is a state-required insurance plan - the coverage of which provides benefits to employees and their dependents for work related injury - illness or death. Each state has an established minimum number of employees required before this law comes into e






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






45. 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






46. forms the roof of the nasal cavity.






47. Superior and widest bone






48. There are also terms indented two spaces to the right below the main term called subterms. These subterms are because they have bearing in the selection of the right code. Everything in the Index is listed by condition - that is - diagnosis - signs -






49. The bone is broken and pierces an internal organ






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