Test your basic knowledge |

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. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.






2. 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.

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183


3. Was developed to protect healthcare professionals from liability of any civil damages as a result of rendering emergency care.






4. Are temporary codes for emerging technology - services and procedures. If a Category III code is available - it is reported instead of a Category I unlisted code.






5. A physician has a separate PPIN for each group office/clinic in which he or she practices. In the Medicare program - in addition to a group number - each member of a group is issued an 8-character performing provider identification number.






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






7. 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






8. 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






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






10. Indicates add-on codes






11. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called






12. A chronological account of the development of the complaint from the first sign or symptom that the patient experienced to the present






13. Absence of hair from areas where it normally grows






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






15. provides a five-digit code which gives the highest specificity of description to a condition. Use of it is mandatory if it is available. A code not reported to the full number of digits required is invalid. e.g. 240.01 Toxic diffuse goiter with thyr






16. Law passed by the federal government to prosecute cases of Medicaid fraud.






17. 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'.






18. 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






19. Represents a change in the code description since the last edition. The change may be minor or significant and it could be an addition - deletion or revision.






20. 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






21. the bone is crushed and or shattered.






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






23. 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






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






25. Also called 'global surgery' - includes a variety of services rendered by a surgeon which includes the following: Surgical procedure performed Local infiltration - metacarpal/metatarsal/digital block - or topical anesthesia Preoperative E/M services






26. Cheekbone






27. 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.






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






29. Hair fibers are composed of tightly fused meshwork of cells filled with hard protein called






30. Is the type of plan a patient may have where they can see providers outside their plan. The patient is responsible to pay the higher portion of the fee.






31. Represents a change in the code description since the last edition. The change may be minor or significant and it could be an addition - deletion or revision.






32. Deficient in pigment (melanin)






33. 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






34.






35. Further classified as to primary - secondary - or carcinoma in situ.






36. This modifier is used to indicate that the procedure was done by an outside laboratory and not by the reporting facility or clinic.






37. includes the shoulder girdle which is made up of the scapula - clavicle and upper extremities. The scapula - or shoulder blades are flat bones that help support the arms. The clavicle - or collarbone - is curved horizontal bones that attach to the u






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






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






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






41. make up part of the roof of the mouth






42. 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.






43. 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).






44. This number is used instead of the individual physician's number for the performing provider who is a member of a group practice that submits claims to insurance companies under the group name.






45. requires investigation and needs further clarification.






46. 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.






47. The fractured area of bone collapses on itself.






48. Families - pregnant women - and children ;Aid to Families with Dependent Children (AFDC)-related groups ;Non-AFDC pregnant women and children;Aged and disabled persons ;Supplemental Security Income (SSI)-related groups ;Qualified Medicare Beneficiari






49. 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.






50. To report a circumstance in which the physician returns to the operating room to address a complication stemming from the initial procedure - modifier -78 is attached to the subsequent procedure code.