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






2. Absence of hair from areas where it normally grows






3. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.






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






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






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






7. This is not specified as benign or malignant in the diagnosis or medical record.






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






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






10. 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






11. Absence of hair from areas where it normally grows






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. Is a regionally managed healthcare program for active duty and retired members of the armed forces - their families - and survivors. It is a service benefit program and contains no premium. TRICARE is the new title for the CHAMPUS program (Civilian H






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






15. 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






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. make up part of the roof of the mouth






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






19. 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






20. Is a brief statement describing the symptom - problem - diagnosis - or condition that is the reason a patient seeks medical care.






21. 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.






22. This is the inventory of the constitutional symptoms regarding the various body systems.






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






24. 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






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






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






27. 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






28. is defined as one who has not received any medical services within the last three years.






29. 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






30. Noninvasive - non-spreading - nonmalignant






31. 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






32. uncertain whether benign or malignant; borderline malignancy






33. 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






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






35. 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






36. Is an insurance company that bids for a contract with CMS to handle the Medicare program in a specific area.






37. The lower anterior part of the bone






38. The musculoskeletal system includes the bones - muscles - and joints The musculoskeletal system acts as a framework for the organs - protects many of those organs - and also provides the organism the ability to move..






39. Prescription Drugs The Medicare Prescription Drug - Improvement - and Modernization Act enacted in December 2003 and began implementation in January 2006 where Medicare beneficiaries can enroll in the Medicare prescription drug plan. The beneficiari






40. Deals with the prevention of healthcare fraud and abuse of patients on Medicare and Medicaid.






41. Is the lateral lower arm bone (in line with the thumb).






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






43. major skin pigment






44. 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






45. 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






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






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






48. .. lower jaw bone.






49. The Usual - Customary - and Reasonable: The UCR method is used mostly in reference to fee-for-service reimbursement. To arrive at a payment amount for a claim - the carrier compares: The physician's most frequent charge for a given service (the usual






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