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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. death of tissue associated with loss of blood supply






2. 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






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






4. This involves the use of relative value scales which assign a relative weight to individual services according to the basis for the scale. Services that are more difficult - time consuming - or resource intensive to perform typically have higher rela






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






6. 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.






7. 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






8. Deficient in pigment (melanin)






9. The spinal /vertebral column is divided into five regions from the neck to the tailbone. There are 26 bones in the spine and they are referred to as the vertebrae. The following list explains the bones of the spine: Cervical -Neck Bones -Thoracic -U






10. 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






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






12.






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






14. Poisoning cannot be determined whether intentional or accidental.






15. 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






16. 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






17. This is used to indicate that the service provided was required by a third-party payer - governmental - legislative - or regulatory body. This does not include second opinion requested by a patient - family member - or another physician.






18. 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






19. Small collection of clear fluid;blister






20. 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.






21. 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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22. Is a working diagnosis which is not yet established.






23. Produce secretions that allow the body to be moisturized or cooled.






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






25. are found covering soft body parts. These are the shoulder blades - ribs - and pelvic bones.






26. Is defined as a doctor of medicine or osteopathy - dental medicine - dental surgery - podiatric medicine - optometry - or chiropractic medicine legally authorized to practice by the state in which he/she performs.






27. poisoning was inflicted by another person with intent to kill or injure






28. 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.






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






30. 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.






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






32. 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






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






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






35. 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






36. Is a service performed by a physician whose opinion or advice is requested by another physician in the evaluation or treatment of a patient's illness or suspected problem. The consultant does not assume responsibility for the patient's care and must






37. 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






38. Also known as Federal tax identification number. This is issued by the Internal Revenue Service






39. are composed of a group of three-digit categories representing a group of conditions or related conditions; they are divided into categories. e.g. . - Disorders of Thyroid Gland (240 - 246).






40. 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.






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






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






43. Mild or controlled hypertension and no damage to the vascular system or organs.






44. Groove or crack like sore






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






46. Is the qualifying factor or factors that must be met before a patient receives benefits.






47. 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.






48. Is defined as someone who has received medical services with in the last 3 years from the physician or another physician of the same specialty who belongs to the same group practice.






49. is basically the same as HMO in the sense that the health care provider enters into contract with the MCOs to render services to the beneficiaries. However - PPO's charge a higher premium than HMO's in exchange for more flexibility and more options






50. Mild or controlled hypertension and no damage to the vascular system or organs.