Billing & Coding

Question 1

Diagnosis codes

Answer 1

alphanumeric codes identify diseases, disorders, symptoms, injuries and other reasons for patient encounters

Question 2

Procedure codes

Answer 2

numeric codes identify commonly accepted descriptions of medical procedures, services and supplies

Question 3

health insurance claim

Answer 3

physician’s request for payment from an insurance company for covered services, procedures and supplies provided to the patient

Question 4

payer

Answer 4

insurance company that provides healthcare coverage; sometimes referred to as the third party payer

Question 5

scope of practice

Answer 5

performing certain services that are consistent with education, training and experience

Question 6

malpractice

Answer 6

bad practice
refers to any professional behavior that results in harm to another individual

Question 7

ambulatory

Answer 7

healthcare setting where services are provided on an outpatient basis, without admission to a hospital or other facility

Question 8

healthcare provider

Answer 8

person licensed, certified or permitted by law to administer healthcare and establish the patient’s diagnosis and treatment plan

Question 9

certification

Answer 9

implies that an individual has met competencies in his or her field, ranging from entry-level skills to expert ones.