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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. Forms the sides of the cranium






2. 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






3. 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






4. A neoplasm is identified; however - no nature of the tumor is documented in the diagnosis or medical record.






5. Lower portion of the pelvic bone






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






7. make up part of the roof of the mouth






8. 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.






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






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






11. 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






12. 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






13. 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






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






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






16. Was created to provide medical benefits to spouses and children of veterans with total - permanent service related disabilities or for surviving spouses and children of a veteran who died as a result of service-related disability. It is a service ben






17. Is defined by Medicare as 'the determination that a service or procedure rendered is reasonable and necessary for the diagnosis or treatment of an illness or injury.'






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






20. 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).






21. 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






22. Is a service performed by a physician whose opinion or advice is requested by another physician in the evaluation or treatment of a patient's illness or suspected problem. The consultant does not assume responsibility for the patient's care and must






23. 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






24. Is made up of the shoulder - collar - pelvic and arms and legs






25.






26. death of tissue associated with loss of blood supply






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






28. Is made up of the shoulder - collar - pelvic and arms and legs






29. Physicians agree to provide services at a discount of their usual fee in return for a pool of existing patients.






30. Absence of hair from areas where it normally grows






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






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. Are wrist bones. There are 2 rows of four bones in the wrist. The metacarpals are the five radiating bones in the fingers. These are the bones in the palm of the hand.






34. Is a policy that covers losses to a third party caused by the insured - by an object owned by the insured - or on premises owned by the insured. Liability insurance claims are made to cover the cost of medical care for traumatic injuries - lost wages






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






36. Identifies code pairs that - for clinical reason - are unlikely to be performed on the same patient on the same day.






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






38. A fat cell






39. 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.






40. 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.






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






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






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






44. requires investigation and needs further clarification.






45. Are supplementary classification codes used to identify health care encounters that occur for reasons other than illness or injury or to identify patients whose illness is influenced by special circumstances or problems. The codes can be found in bot






46. death of tissue associated with loss of blood supply






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






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






50. found in the Index under the main term 'Hypertension' - and it contains a list of conditions that are due to or associated with hypertension. The table classifies the conditions as: