Anatomy & Physiology Terminology
Insurance & Claims Processing
Billing
ICD-10-CM/ CPT Coding
Human Diseases & Pathology
100
Bleeding, Blood Loss
Hemorrhage
100
claims are reviewed and payments decisions are made by payer
What is Aducation?
100
also referred to as Remittance Advice (RA
What is an EOB (Explanation of Benefits)
100
99204
Office or out patient visit for the evaluation and management of a new patient
100
Disease that spreads from person to person
What is an infectious disease?
200
Inflammation of liver
Hepatitis
200
by law needs to be signed by patient before claim can be processed
Release of Information
200
a business entity that consolidates claims and transmits to the 3rd party payer
What is a clearing house
200
99214
Office or other outpatient visit for evaluation and management of an established patient
200
Overuse of antibiotics
What causes antibiotic- resistant bacteria?
300
The study of disease
Pathology
300
CMS 1500 form filled out without mistakes
What is a clean claim?
300
arrangements made by the patient to allow direct payment to the provider
What is assignment of benefits (AOB)?
300
99231
Subsequent hospital care
300
Deer tick
What is a transmitter for Lyme disease?
400
Right sided paralysis
Hemiplegia
400
can be filled if heath care professional or patient feels claim is wrongfully denied
What is an appeal?
400
needs to determine which payer is primary or secondary
What is Coordination of Benefits
400
59400
Vaginal delivery
400
A disease that occurs suddenly and spreads rapidly to many people
What is an epidemic disease?
500
The brain disorder marked by gradual and progressive mental deterioration, personality changes, and impairment of daily function
Alzheimer Disease (AD)
500
claim approved by AMA council and adopted by all government health care programs
CMS 1500
500
61624
500
Leukaemia
What is blood cancer known as?
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