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Medical Billing And Coding Vocab

Instructions:
  • Answer 50 questions in 15 minutes.
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  • Match each statement with the correct term.
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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. Is the cost of insurance coverage paid annually - semi-annually or monthly to keep a policy in effect.






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






3. Is the lower medial arm bone.






4. A fat cell






5. The CPT Index is arranged in alphabetical order by main terms which are further divided by subterms. There are five location methods: 1. Service or Procedure 2. Anatomic site 3. Condition or Disease 4. Synonym/Eponym 5. Abbreviation






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. Unlike the RBRVS - the RVP has no geographic adjustment factor or individual RVU component to calculate. However - for each category of procedures - a separate conversion factor must be developed....






9. There are 12 pairs of ribs. The first 7 pairs join the sternum anteriorly through cartilaginous attachments called costal cartilages.






10. 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.






11. When a group of employees and their dependents are insured under one (1) group policy issued to the employer. Generally - the employer pays the premium or a portion of the premium and the employee pays the difference. This all depends on the type of






12. When a group of employees and their dependents are insured under one (1) group policy issued to the employer. Generally - the employer pays the premium or a portion of the premium and the employee pays the difference. This all depends on the type of






13. 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).






14. Upper jaw bone






15. The skin and its accessory organs.Integument means covering. The skin covers over an area of 22 square feet ( an average adult). It is a complex system of specialized tissues containing glands - nerves and blood vessels. The main function of the skin






16. 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..






17. 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.






18. Is the process of converting diagnoses - procedures - and services into numeric and alphanumeric characters.






19. 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.






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






21. Used for procedures that is always performed during the same operative session as another surgery in addition to the primary service/procedure and is never performed separately.






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






23. 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






24. 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






25. 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






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






27. 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






28. Deficient in pigment (melanin)






29. 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.






30. Mild or controlled hypertension and no damage to the vascular system or organs.






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






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






33. Bone that forms posterior/inferior part of the nasal septal wall between the nostrils.






34. Is a group of two or more physicians and non-physician practitioners legally organized in a partnership - professional corporation - foundation - not-for-profit corporation - faculty practice plan - or similar association.






35. male of household is primary payer






36. 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.






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






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






39. The fractured area of bone collapses on itself.






40. 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






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






42. 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






43. 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.






44. is one who has not received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years.






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






46. 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....






47. anterior to the temporal bones.






48. This modifier is used when the same procedure is performed on a mirror-image part of the body..






49. 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






50. Are supplemental codes used for performance measurements. Although these codes are intended to facilitate data collection about the quality of care - their use is optional. Category II codes are published twice a year: January 1st and July 1st.







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