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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. The reason the patient came to see the physician.






2. forms the two lower sides of the cranium.






3. Is defined by Medicare as 'the determination that a service or procedure rendered is reasonable and necessary for the diagnosis or treatment of an illness or injury.'






4. Was developed to promote the interests and well being of the patients and residents of the healthcare facility. This bill has still not become a law.

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5. cancer that is localized and has not spread to adjacent tissues or distant parts of the body






6. This modifier is used when: more than one procedure is performed during the same surgical episode; one code does not describe all of the procedures performed; and the secondary procedure is not minor or incidental to the major procedure. The followin






7. open sore on the skin or mucous






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






9. Deficient in pigment (melanin)






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






11. 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.






12. Is when two insurance companies work together to coordinate payment of the benefits.






13. Diathroses are joints that have free movement. Ball-and-socket joints (hip) and hinge joints (knees) are common diathroses joints. (synovial joints)






14. death of tissue associated with loss of blood supply






15. Contain the full description of the procedure for the code indented codes: these are codes listed under associated stand-alone codes. To complete the description for indented codes - one must refer to the portion of the stand alone code description b






16. 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






17. - To pay for medical services and items that Medicare does not cover and Medicare's coinsurance and deductibles - beneficiaries may purchase a supplemental insurance. Medigap is a private insurance designed to help pay for those amounts that are typ






18. major skin pigment






19. Is the upper arm bone.






20. 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.






21.






22. requires investigation and needs further clarification.






23. 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






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






25. solid - round or oval elevated lesion more than 1 cm in diameter






26. The lower anterior part of the bone






27. 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.






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






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






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






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






32. Absence of hair from areas where it normally grows






33. 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.






34.






35. Also called 'global surgery' - includes a variety of services rendered by a surgeon which includes the following: Surgical procedure performed Local infiltration - metacarpal/metatarsal/digital block - or topical anesthesia Preoperative E/M services






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






37. Structural protein found in the skin and connective tissue






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






39. 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






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






41. Is the cost of insurance coverage paid annually - semi-annually or monthly to keep a policy in effect.






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






43. is referred to as Supplementary Medical Insurance (SMI). This coverage is a supplement to Part A - which covers medical expenses - clinical laboratory services - home health care - outpatient hospital treatment - blood - and ambulatory surgical serv






44. means the provider agrees to accept what the insurance company approves as payment in full for the claim.






45. 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






46. Number assigned to the physician by Medicare program.






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






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






49. Is an electronic or paper-based report of payment sent by the payer to the provider.






50. 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..







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