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Test your basic knowledge |

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. 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.






2. Is the type of plan a patient may have where they can see providers outside their plan. The patient is responsible to pay the higher portion of the fee.






3. This modifier is used to report a procedure or service that has more than one Modifier but the third-party payer does not allow the addition of multiple modifiers to the code. Modifier -99 is attached to the procedure code and the multiple Modifiers






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






5. This is not specified as benign or malignant in the diagnosis or medical record.






6. death of tissue associated with loss of blood supply






7.






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






9. They are for profit organizations that operate in the private sector selling different health insurance benefits plans to groups or individuals. Most commercial plans have predefined patient yearly deductibles and coinsurance generally based on 80/2






10. 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.






11. 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






12. 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.






13. 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






14. Are supplementary classification codes used to describe the reason or external cause of injury - poisoning and other adverse effects. These codes can be found in both Volumes I and II. E codes are used to classify environmental events - circumstances






15. Are small - rounded bones that resemble a sesame seed. They are found near joints and increase the efficiency of muscles near a joint. An example of sesamoid bone is the knee cap.






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






17. 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






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






19. 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






20. It is important that every patient seen by the physician has comprehensive legible documentation about the patient's illness - treatment and plans for the following reasons Avoidance of denied or delayed payments by insurance carriers investigating t






21. 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.






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






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






24. Created the Health Care Fraud and Abuse Control Program enacted to check for fraud and abuse in the Medicare and Medicaid programs - and private payers.






25. Bacterial inflammatory skin disease characterized by lesion - pustules and vesicles.






26. A fracture of the epiphyseal plate in children.






27. The cuticle at the lower part of the nail and this is sometimes referred to as the






28. Upper jaw bone






29. .. lower jaw bone.






30. numbers 8-10 - are attached to the sternum by cartilage






31. Numbers 1-7 - attach directly to the sternum in the front of the body.






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






33. Is the upper arm bone.






34. male of household is primary payer






35. forms the roof of the nasal cavity.






36. Is a percentage of the cost of covered services that a policyholder or a secondary insurance pays. A common payment percentage for coinsurance is 80/20 which indicates that 20% is the coinsurance for which the beneficiary or secondary insurance is re






37. provides a five-digit code which gives the highest specificity of description to a condition. Use of it is mandatory if it is available. A code not reported to the full number of digits required is invalid. e.g. 240.01 Toxic diffuse goiter with thyr






38. includes the shoulder girdle which is made up of the scapula - clavicle and upper extremities. The scapula - or shoulder blades are flat bones that help support the arms. The clavicle - or collarbone - is curved horizontal bones that attach to the u






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






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






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






42. Number assigned to the physician by Medicare program.






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






44. 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






45. This is also known as fee-for-service. Under this plan - the services that are paid for are listed in the policy and payments are based on the fees physicians charge for the service. Each year - the beneficiary must meet a deductible - after which -






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






47. 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


48. Structural protein found in the skin and connective tissue






49. 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






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






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