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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. Any fracture occurring spontaneously as a result of disease.






2. most synarthroses are immovable joints held together by fibrous tissue.






3. Is a fee that is charged for each procedure or service performed by the physician. This fee is obtained from a fee schedule - which is a list of charges or allowance that have accepted for specific medical services. The system in which fee schedules






4. 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.






5. 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.






6. anterior to the temporal bones.






7. Lower portion of the pelvic bone






8. These parenthetic terms are called because their presence or absence does not have an effect on the selection of the code listed for the main term.






9. 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.






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






11. The poisoning was self-inflicted.






12. 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.






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






14. Superior and widest bone






15. forms the two lower sides of the cranium.






16. Absence of hair from areas where it normally grows






17. 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






18. Includes - but is not limited to - physician assistant - certified nurse-midwife - qualified psychologist - nurse practitioner - clinical social worker - physical therapist - occupational therapist - respiratory therapist - certified registered nurse






19. 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.






20. Is a managed care benefits plan that provides a wide range of medical services to individuals that have been enrolled into the program. It is generally the least costly but at the same time also the most restrictive. This plan uses a gatekeeper physi






21. Is to determine the patient's benefits and the maximum dollar amount that the insurance company will pay. Often the first step of the insurance verification process - it is completed prior to the first visit.






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






23. Is a patient who receives treatment in any of the following settings: physician's office ;hospital clinic - emergency department - hospital same-day surgery unit - ambulatory surgical center ( patient is released within 23 hours) ;hospital admission






24. Is the lower medial arm bone.






25. This modifier is used to explain that the procedure or service done during a postoperative period was planned at the time of the original procedure. This is also used if a therapeutic procedure is performed because of the findings from a diagnostic p






26. Is a statement of the patient's account history - showing dates of service - detailed charges - payments (i.e. deductibles and co-pays) - the date the insurance claim was submitted - applicable adjustments and account balance.






27. Absence of hair from areas where it normally grows






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






29. Families - pregnant women - and children ;Aid to Families with Dependent Children (AFDC)-related groups ;Non-AFDC pregnant women and children;Aged and disabled persons ;Supplemental Security Income (SSI)-related groups ;Qualified Medicare Beneficiari






30. This is any procedure or service reported on the insurance claim that is not listed in the payer's master benefit list. This will result in the denial of the claim. Providers may be able to recover the charges from the patient.






31. Is a term used when a patient is admitted to the hospital with the expectation that the patient will stay for a period of 24 hours or more.






32. death of tissue associated with loss of blood supply






33. .. lower jaw bone.






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






35. 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






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






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






38. The lower anterior part of the bone






39. 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






40. Is to determine the patient's benefits and the maximum dollar amount that the insurance company will pay. Often the first step of the insurance verification process - it is completed prior to the first visit.






41. Is a state-required insurance plan - the coverage of which provides benefits to employees and their dependents for work related injury - illness or death. Each state has an established minimum number of employees required before this law comes into e






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






43. 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..






44. 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.






45. forms the back of the skull. There is a large hole at the ventral surface in this bone - called the foramen magnum - which allows the brain communication with the spinal cord






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






47. This is the index for the E codes.It classifies - in alphabetical order - environmental events and other conditions as the cause of injury and other adverse effects.






48. Federal law that prohibits submitting a fraudulent claim or making a false statement or representation in connection with a claim. It also protects and rewards persons involved in whistle-blower cases.






49. All patients have a right to privacy and all information should remain privileged. Discuss patient information only with the patient's physician or office personnel that need certain information to do their job. Obtain a signed consent form to releas






50. Superior and widest bone