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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. represents Exemption from the use of modifier -51






2. Indicates add-on codes






3. 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






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






5. 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.






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






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






8. Are located in the dermal layer of the skin over the entire body - except for the palms of the hands and soles of the feet. The sebaceous glands secrete an oily substance called sebum. Sebum contains lipids that help lubricate the skin and minimize w






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






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






11. Is one who has received professional services from the physician or another physician of the same specialty in the same group within the past three (3) years....






12. 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






13. This number is used instead of the individual physician's number for the performing provider who is a member of a group practice that submits claims to insurance companies under the group name.






14. This is a set of information the physician gathers from the patient regarding the following:






15. The reason the patient came to see the physician.






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






17. Make up part of the interior of the nose.






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






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






20. anterior to the temporal bones.






21. Medically indigent low-income individuals and families ;Low-income persons losing employer health insurance coverage ( Medicaid purchase of COBRA coverage)






22. The bone is broken and pierces an internal organ






23. Is a state based group of physicians working under government guideline to review cases and determine their appropriateness and quality of professional care.






24. 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






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






26. 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.






27. consists of 17 chapters based on either body system or cause or type of disease. The codes range from 001-999.






28. This is the inventory of the constitutional symptoms regarding the various body systems.






29. 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






30. 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






31. This is defined as incidents or practices - not usually considered fraudulent - that are inconsistent with the accepted medical business or fiscal practices in the industry. Examples of abuse are submitting a claim for a service or procedure performe






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






33. 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






34. 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






35. Are located in the dermal layer of the skin over the entire body - except for the palms of the hands and soles of the feet. The sebaceous glands secrete an oily substance called sebum. Sebum contains lipids that help lubricate the skin and minimize w






36.






37. 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.






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






39. 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..






40. Is a policy that covers losses to a third party caused by the insured - by an object owned by the insured - or on premises owned by the insured. Liability insurance claims are made to cover the cost of medical care for traumatic injuries - lost wages






41. 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.






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






43. 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.






44. Law passed by the federal government to prosecute cases of Medicaid fraud.






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






46. Number assigned to the physician by Medicare program.






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






48. 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.






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






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







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