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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. Superior and widest bone






2. 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






3. The bone is broken and pierces an internal organ






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






5. Upper jaw bone






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






7. Is an entity that receives transmissions of claims from physicians' offices - separates the claims by carriers and performs software edits on each claim to check for errors. Once this process is complete - the claim is then sent to the proper insuran






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






9. 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).






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






11. 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






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






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






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






16. Also known as Federal tax identification number. This is issued by the Internal Revenue Service






17. This is attached to the code of the E/M service provided to a patient during the postoperative period to indicate that that service is not part of the postoperative care which is usually part of a package of services of the surgery performed. Major s






18. Poisoning was due to: Accidental overdose; Wrong substance taken; Accidents in use of drugs and biologicals; External causes of poisonings classifiable to 980-989 Therapeutic Use: instances when a correct substance properly taken is the cause of adve






19. Is to determine coverage for a specific treatment such as surgery - hospitalization or tests - under the insured's policy.






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






21. 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.






22. 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






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. Eccrine sweat glands are the most common and the apocrine sweat glands that secrete an odorless sweat.






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






26. anterior to the temporal bones.






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






28. 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..






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






30. Forms the anterior part of the skull and the forehead






31. 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.






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






33. Most billing-related cases are based on HIPAA and False Claims Act.






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






36. A minor fracture appears as a thin line on x-ray and may not extend completely through the bone.






37. the bone is crushed and or shattered.






38. The moon like white area at the base of the nail.






39. 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






40. 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.






41. Medicare Managed Care Plans (Formerly Medicare Plus (+) Choice Plan) was created to offer a number of healthcare services in addition to those available under Part A and Part B. The CMS contracts with managed care plans or provider service organizati






42. Forms the sides of the cranium






43. requires investigation and needs further clarification.






44. This modifier is used to indicate that the procedure or service provided during the postoperative period was not associated with the initial procedure. Payment for the full fee of the subsequent procedure is requested and a new global period starts.






45. Has all required fields accurately filled out - contains no deficiencies and passes all edits. The carrier does not require investigation outside of the carrier's operation before paying the claim.






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






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






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






49. A fat cell






50. 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