Terminology
Billing and Coding
Medicare
CMS 1500
Anything Goes!
100
A specific amount of money that must be paid yearly before the benefits begin.
What is a Deductible?
100

What is the purpose of a CPT code

explains procedures

100
Offered to all medicare recipients to cover the cost of their prescription drugs.
What is Medicare Part D
100

This field contains the patient's insurance ID#

1a

100

In a standard SOAP note, the "O" stands for:

objective

200

The person who "owns" the insurance contract.

Subscriber

200

What is the purpose of an ICD-10-CM code

explains the diagnosis

200
Covers outpatient health care services, services by physicians and durable medical equipment.
What is Medicare Part B
200

This field contains a combination of copayments made, insurance payments received, and reductions.  

Block 29
200

In a standard SOAP note, the "S" stands for:

subjective

300

Additions to insurance policies, such as vision and dental, that are optional and require additional payment.  

Rider

300

What type of code uses a "modifier"

CPT code

300
Inpatient health care services, services in hospitals, nursing facilities, home health care, and hospice care.
What is Medicare Part A
300

This field contains the referring physician's NPI#

17b

300

In a standard SOAP note, the "P" stands for:

plan

400
The amount you pay each month to belong to a health plan.
What is a Premium?
400

Who is considered to be the subscriber to a Medicare claim?

the patient, or "self"

400

Some varieties of this plan may require members to pay a premium similar to the Medicare Part B premium.

What is Medicare Part C

400

This field contains the patient's diagnosis codes

21

400

In a standard SOAP note, the "A" stands for:

assessment

500

MBI, or Medicare Beneficiary ID was once called this:

HIC#

500

True or False:  Every insurance plan has a group number that shows on the insurance ID card.

False

500

A separate pot of money that covers a specific set of Medicare beneficiaries.

Railroad Medicare

500

This field contains the number of units of a procedure or service the patient received. 

24g

500

In documenting an encounter note, the section labeled "CC" at the beginning of the note stands for this.

chief complaint

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