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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. 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.






2. 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






3. 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






4. Groove or crack like sore






5. 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.






6. Cheekbone






7. A fracture of the epiphyseal plate in children.






8. found in the Index under the main term 'Hypertension' - and it contains a list of conditions that are due to or associated with hypertension. The table classifies the conditions as:






9. The bones are connected to one another by fibrous bands of tissue . Muscles are attached to the bone by tendons. The fibrous covering of the muscles is called the fascia






10. forms the two lower sides of the cranium.






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






12. The bone is broken and pierces an internal organ






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. 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






15. Is a regionally managed healthcare program for active duty and retired members of the armed forces - their families - and survivors. It is a service benefit program and contains no premium. TRICARE is the new title for the CHAMPUS program (Civilian H






16. amphiathroses are joints joined together by cartilage that is slightly moveable - such as the vertebrae of the spine or the pubic bone.






17. 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






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






19. The plan of the parent whose birthday falls earlier in the year (month and day - not year) is primary to that whose birthday falls later in the year. If both parents have the same birthday - then the plan of the parent who has had the longest coverag






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






21. Number assigned to the physician by Medicare program.






22. This modifier is used to indicate that the procedure was done by an outside laboratory and not by the reporting facility or clinic.






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






24. 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.






25. 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






26. 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






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






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






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






30. A medical record is documentation on the patient's social and medical history - family history - physical examination findings - progress notes - radiology and lab results - consultation reports and correspondence to patient.






31. Are temporary codes for emerging technology - services and procedures. If a Category III code is available - it is reported instead of a Category I unlisted code.






32. 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.






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






34. 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






35. requires investigation and needs further clarification.






36. 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.






37. The fractured area of bone collapses on itself.






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






39. Are temporary codes for emerging technology - services and procedures. If a Category III code is available - it is reported instead of a Category I unlisted code.






40. Physicians are legally responsible for their own conduct and any actions of their employees (their designee) performed within the context of their employment. This is referred to as 'vicarious liability -' also known as 'respondent superior -' which






41. 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






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






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






44. 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.






45. 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).






46.






47. 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






48. is a traumatic injury to a joint involving the soft tissue.






49. Typically not used on the claim form unless the provider does not have an EIN.






50. Is the upper arm bone.