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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. Indicates add-on codes






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






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






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






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






6. 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






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






8. .. lower jaw bone.






9. The spinal /vertebral column is divided into five regions from the neck to the tailbone. There are 26 bones in the spine and they are referred to as the vertebrae. The following list explains the bones of the spine: Cervical -Neck Bones -Thoracic -U






10. 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.






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






12. This is used to indicate that the service provided was required by a third-party payer - governmental - legislative - or regulatory body. This does not include second opinion requested by a patient - family member - or another physician.






13. Provide a four-digit code (one digit after the decimal point) which is more specific than category code (3-digit) in terms of cause - site - or manifestation of the condition. This must be used if available. From subcategory - specificity moves to an






14. make up part of the roof of the mouth






15. 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






16. paired bones at the corner of each eye that cradle the tear ducts.






17. A fracture of the epiphyseal plate in children.






18. Cheekbone






19. Is one who has a contract with a health insurance plan and accepts whatever the plan pays for procedures or services rendered.






20. 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






21. Is the lower medial arm bone.






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






23. Identifies code pairs that should not be billed together because one code (Column 1) includes all the services described by another code (Column 2).






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






25. 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.






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






27. Considered experimental - newly approved - or seldom used may not be listed in the CPT manual. These codes can be coded as unlisted procedures. They are located at the end of the subsections or subheadings. When an unlisted procedure code is reported






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






29. An insurance plan issued to an individual. Premium rates are usually higher than group rates and service availability is lessened with this type of coverage.






30. 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....






31. This is also known as fee-for-service. Under this plan - the services that are paid for are listed in the policy and payments are based on the fees physicians charge for the service. Each year - the beneficiary must meet a deductible - after which -






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






33. Upper jaw bone






34. 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.






35. The poisoning was self-inflicted.






36. 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....






37. There are also terms indented two spaces to the right below the main term called subterms. These subterms are because they have bearing in the selection of the right code. Everything in the Index is listed by condition - that is - diagnosis - signs -






38. 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).






39. 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






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






41. Is a working diagnosis which is not yet established.






42. requires investigation and needs further clarification.






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. 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






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






46. 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






47. Benign growth extending from the surface of the mucous membrane






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






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






50. death of tissue associated with loss of blood supply