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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. HCPCS Reference Manual The CMS assigns a standard unique identifier known as the National Provider Identifier (NPI) The CMS also developed a two-part coding system called the Healthcare Common Procedure Coding System ( HCPCS ) which is a collection o






2. 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






3. Forms the sides of the cranium






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






5. This consists of the patient's personal experiences with illnesses - surgeries and injuries. It also contains information of illnesses predominant in the family. It contains the patient's educational background - occupation - marital status - and oth






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






7. Retention of medical records is governed by state and local laws and may vary from state-to-state. Most physicians are required to retain records indefinitely; deceased patient records should be kept for at least five (5) years.






8. Describes the services billed and includes a breakdown of how the payment is determined






9. Various terms are used to describe the state of submitted forms. The following are some of the terms that are typically used by insurance carriers.






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






11. 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






12. Noninvasive - non-spreading - nonmalignant






13. 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.






14. 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.






15. A fat cell






16. Is defined as a doctor of medicine or osteopathy - dental medicine - dental surgery - podiatric medicine - optometry - or chiropractic medicine legally authorized to practice by the state in which he/she performs.






17. Is also called the superbill; it is a listing of the diagnoses - procedures - and charges for a patient's visit.






18. 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.






19. The poisoning was self-inflicted.






20. The lower anterior part of the bone






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






22. Various terms are used to describe the state of submitted forms. The following are some of the terms that are typically used by insurance carriers.






23.






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






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






26. the bone is crushed and or shattered.






27. Forms the sides of the cranium






28. 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






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






30. Any fracture occurring spontaneously as a result of disease.






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. Is the lower medial arm bone.






33. Also called the Hospital Insurance for the Aged and Disabled. It covers institutional providers for inpatient - hospice - and home health services - such as the






34. 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






35. This involves the use of relative value scales which assign a relative weight to individual services according to the basis for the scale. Services that are more difficult - time consuming - or resource intensive to perform typically have higher rela






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






37. The CPT manual is composed of eight sections. Each section begins with guidelines that provide specific coding rules for that section. Guidelines at the beginning of the section are applicable to all codes in the section - while notes that pertain t






38. Is one who has no contract with the health insurance plan.






39. open sore on the skin or mucous






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






41. Number assigned by the insurance company to a physician who renders services to patients.






42. 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






43. 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






44. 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






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






46. 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






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






48. Is a document provided to a Medicare beneficiary by a provider prior to service being rendered letting the beneficiary know of his/her responsibility to pay if Medicare denies the claim.






49. poisoning was inflicted by another person with intent to kill or injure






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