Matching Quizzes/tests/exams

Front 1

Requiring diagnosis codes to be reported on submitted claim

Back 1

Medical necessity

Front 2

Automates the coding process used in computerized or web-based software

Back 2

Encoder

Front 3

Condition determined after study which resulted in the patient admission to the hospital

Back 3

Principal diagnosis

Front 4

Commorbidities and complications

Back 4

Secondary diagnosis

Front 5

Encounter codes for circumstances other than disease or injury

Back 5

V codes

Front 6

Index to diseases

Back 6

Volume II

Front 7

Supplementary words in parentheses after a main term

Back 7

Nonessential modifiers

Front 8

Cataloging diseases and procedures by code number

Back 8

Indexing

Front 9

Disorder diagnosed in infants at birth

Back 9

Congenital anomalies

Front 10

External causes of injuries and poisonings

Back 10

E codes

Front 11

Adjudication

Back 11

Disputes resolution process in which appeals board makes final decision

Front 12

Federal program

Back 12

Energy employees occupational illness compensation program

Front 13

Budget chargeback process

Back 13

Transfer of funds from responsible federal agency's budget to the DFEC

Front 14

State insurance or compensation fund

Back 14

Fiscal agent designated by state law in the corporation involved

Front 15

Federal black lung program

Back 15

Monthly benefits to coal miners

Front 16

Compensation file

Back 16

Created by providers for established patients injured on the job

Front 17

Worker's Compensation Board of commission

Back 17

State agency responsible for providing payments to dependents of deceased covered worker

Front 18

First report of injury

Back 18

Form filed with the state Workers' Compensation Board/commission

Front 19

Deposition

Back 19

Legal proceeding during which a party answers questions under oath

Front 20

Survivor benefits

Back 20

Death benefits calculated at time of employee's injury or illness

Front 21

Catchment area

Back 21

Region defined by code boundaries within a 40 mile radius of an MTF

Front 22

Beneficiary services representative

Back 22

Provides information about using TRICARE

Front 23

TRICARE prime

Back 23

Managed-care options similar to HMO

Front 24

Fiscal year

Back 24

Runs from October 1 to September 30

Front 25

Lead agents

Back 25

Federal healthcare team created to work with military treatment facility commanders

Front 26

MTF

Back 26

Health care facility operated by the military

Front 27

Critical pathway

Back 27

Sequence of activities that result in cost-effective course of treatment

Front 28

TRICARE for life

Back 28

Provides Medicare-wraparound coverage

Front 29

Healthcare finder

Back 29

Nurse or physician who assists primary care providers with preauthorization

Front 30

Program integrity office

Back 30

Responsible for surveillance of fraud and abuse activities

Front 31

Spend down to Medicaid eligibility

Back 31

Medically needy

Front 32

TANF

Back 32

Cash assistance for children deprived of support

Front 33

Surveillance and utilization review system

Back 33

Safeguards against inappropriate use of Medicaid services

Front 34

SCHIP

Back 34

State children's health insurance program

Front 35

EPSDT

Back 35

Routine pediatric checkups for all children enrolled in Medicaid

Front 36

Mother/baby claim

Back 36

Services provided to a baby under mother's ID number

Front 37

PACE

Back 37

Alternative care for persons aged 55 or older who require nursing facility level care

Front 38

Community spouse

Back 38

Spouse who is not in a nursing home

Front 39

Voided claim

Back 39

Deduction from lump-sum payment made to provider

Front 40

Medicaid remittance advice

Back 40

Current status of all claims

Front 41

Privacy act of 1974

Back 41

Prohibits release of information

Front 42

Medicare part B

Back 42

Reimburses physicians for physician services, outpatient hospital care, and other services not covered by Medicare part A

Front 43

Lifetime reserve days

Back 43

Used only once during a patient's lifetime

Front 44

Medigap

Back 44

Supplemental insurance

Front 45

Relative value unit

Back 45

Physician work, practice expense, and malpractice expense

Front 46

Medicare part A

Back 46

Reimburses institutional providers for inpatient services

Front 47

Medicare savings accounts

Back 47

Money managed by a Medicare approved insurance company

Front 48

Medicare select

Back 48

Medigap insurance that requires enrollees to use a network of providers in order to receive full benefits

Front 49

General enrollment period

Back 49

Held January 1 through March 31 of each year

Front 50

Benefit period

Back 50

Begins first day of hospitalization

Front 51

Code used to report DEMPOS

Back 51

HCPCS level II

Front 52

Current procedural terminology

Back 52

HCPCS level I

Front 53

Equipment used for medical purposes

Back 53

Durable medical equipment

Front 54

Responsible for annual updates

Back 54

A M A

Front 55

90 day grace.

Back 55

Discontinued

Front 56

Makes decisions regarding additions, revisions, and deletions

Back 56

Permanent national codes

Front 57

Dental codes

Back 57

CDT

Front 58

Not otherwise classified codes

Back 58

Miscellaneous codes

Front 59

Hospital outpatient prospective payment system

Back 59

OPPS

Front 60

HCPCS temporary codes

Back 60

G codes

Front 61

Product is "used equipment"

Back 61

Modifier – UE

Front 62

Table of drugs

Back 62

J codes

Front 63

Location of service or procedure

Back 63

Index

Front 64

Medicare administrative contractor

Back 64

EME MAC

Front 65

Medicare carriers manual

Back 65

MCM

Front 66

Level I HCPCS Codes

Back 66

CPT

Front 67

Emerging technology codes

Back 67

Category III Codes

Front 68

Moderate (conscious) sedation

Back 68

Bull's eye

Front 69

Nature, extent, and need

Back 69

Pertinent information

Front 70

Clarifies assignment of a CPT code

Back 70

Descriptive qualifier

Front 71

Two-digit numeric codes

Back 71

Modifiers

Front 72

Codes that describe specialty services

Back 72

Medicine

Front 73

E/M service with no CPT code

Back 73

Unlisted service

Front 74

Reported with an unlisted service code

Back 74

Special report

Front 75

History, examination, and medical decision making

Back 75

Key components

Front 76

Fifteen-minute increment

Back 76

Anesthesia time unit

Front 77

Outpatient diagnostic laboratory services fee schedule

Back 77

Clinical laboratory fee schedule

Front 78

Pre-determined rate for discharge for inpatient hospital services

Back 78

Retrospective reasonable cost system

Front 79

Measure of types of patients treated

Back 79

Case mix

Front 80

Computer-generated list of procedures

Back 80

Chargemaster

Front 81

CMS-1450

Back 81

UB – 04

Front 82

Software used to assign APCs on CPT and HCPCS level II outpatient claims

Back 82

APC grouper

Front 83

Diagnosis that may not receive treatment during encounter

Back 83

Medically managed

Front 84

Outpatient claims editing software

Back 84

OCE

Front 85

Waiver required for outpatient and physicians' offices for procedures/services not covered by Medicare program

Back 85

ABN

Front 86

Primary purpose of the patient record

Back 86

Continuity of care

Front 87

Narrative description of procedure

Back 87

Operative report

Front 88

Patient's chief complaint

Back 88

Subjective

Front 89

Documentation of physicians' observations or diagnostic test results

Back 89

Objective

Front 90

Diagnostic statement

Back 90

Assessment

Front 91

CMS outpatient claim form

Back 91

CMS 1500