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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. Under this schedule - a procedure's relative value is the sum total of three elements: Work: represents the amount of time - intensity of effort - and medical skill required of the physician. Overhead: practice costs related to the performing of the

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2. This is the traditional method used by providers for submission of charges to insurance companies. The most commonly used form is the CMS-1500. Few plans still accept the physician's encounter form or superbill and Medicare will only accept claims on






3. 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..






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






5. The lower anterior part of the bone






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






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






8. In July 2001 - the Health Care Financing Administration (HCFA) became the Centers for Medicare & Medicaid Services (CMS) - and the universal claim form HCFA-1500 became the CMS-1500.Virtually all third-party payers will accept it - and Medicare requ






9. Under this schedule - a procedure's relative value is the sum total of three elements: Work: represents the amount of time - intensity of effort - and medical skill required of the physician. Overhead: practice costs related to the performing of the

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






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






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






13. 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.






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






15. cancer that is localized and has not spread to adjacent tissues or distant parts of the body






16. '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






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






18. 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






19. The epidermis - the dermis - and the subcutaneous layer. The epidermis is a thin - cellular membrane layer that contains keratin. The dermis is a dense - fibrous - connective tissue that contains collagen. The subcutaneous layer is a thicker and fatt






20. Created the Health Care Fraud and Abuse Control Program enacted to check for fraud and abuse in the Medicare and Medicaid programs - and private payers.






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






22. 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






23. The break of the distal end of the radius at the epiphysis often occurs when the patient has attempted to break his or her fall.






24. 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






25. Is a percentage of the cost of covered services that a policyholder or a secondary insurance pays. A common payment percentage for coinsurance is 80/20 which indicates that 20% is the coinsurance for which the beneficiary or secondary insurance is re






26. Superior and widest bone






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






28. make up part of the roof of the mouth






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






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






31. 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.






32. 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






33. Various terms are used to describe the state of submitted forms. The following are some of the terms that are typically used by insurance carriers.






34. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.






35. Lower portion of the pelvic bone






36. major skin pigment






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






38. forms the roof of the nasal cavity.






39. Are conditions - situations - and services not covered by the insurance carrier.






40. 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).






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






42. This is located in the Index under the main term 'Neoplasm' and is organized by anatomic site. Each site has six columns with six possible codes determined by whether the neoplasm is malignant - benign - of uncertain behavior - or of unspecified natu






43. 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.






44. Indicates add-on codes






45. The bone is broken and pierces an internal organ






46. Represents a new procedure or service code added since the previous edition of the manual.






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






48. 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.






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






50. A medical record is documentation on the patient's social and medical history - family history - physical examination findings - progress notes - radiology and lab results - consultation reports and correspondence to patient.