Billing & Coding week 4

123 terms by yramos1127 

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Billing & Coding week 4 medical terms

beneficiary

in the Medicare program, one who is eligible to receive Medicare benefits for medical coverage or illness or injury or for death benefits.

CMS

centers for medicare and medicaid services.

cobra

consolidated omnibus budget reconciliation act.

correct coding initiative CCI

Bundling edits created by CMS to combine various component items with a major service or procedure.

DME

durable medical equipment.

FI

fiscal intermediary.

HCPCS

Healthcare common procedure coding system.

hospice

an organization (private or public) that provides pain relief, symptom management, and support services to terminally ill patients and their families.

inquiry letter

request from an insurance company for additional information required to process a claim for payment.

limiting charge

typically applies to medicare reimbursement.

locum tenens

a physician who substitutes for another physician who is out of the office for an extended period of time.

medicare

a national health insurance program for persons over the age of 65 and qualified disabled or blind persons regardless of income, administered by CMS.

medicare part A

a national health insurance program for persons over the age of 65 and qualified disabled or blind persons regardless of income, administered by CMS to cover the cost of hospitalizations and nursing facility charges.

medicare part B

an elective coverage program offered by CMS for aged and disabled patients to provide benefits for physician and other medical services as part of the medicare program.

medicare part C

a medicare advantage program that combines part A and B, and sometimes part D (prescription drugs).

medicare part D

program that helps pay for outpatient prescription drugs and may help lower the costs of prescription drugs and help protect against higher costs in the future.

medigap

a specialized insurance policy for Medicare beneficiaries that pays deductibles and co-payment amounts not covered by the medicare program.

medi-medi

insurance coverage by both medicare and medicaid.

NPI

national provider identifier.

PPS

Prospective Payment System.

SOF

Signature on file.

carp/o

wrist bones (carpals).

cib/o

meal

cost/o

rib

cutane/o

skin

dactyl/o

fingers, toes

duct/o

carry

flex/o

bend

furc/o

forking, branching

gloss/o

tongue

glyc/o

glucose,sugar

immun/o

immune, protection

later/o

side

morph/o

shape, form

mort/o, necr/o

death

nat/i

birth

nect/o

bind, tie, connect

norm/o

rule, order

ophthalm/o

eye

ox/o

oxygen

pub/o

pubis (anterior part of the hip)

ren/o

kidney

seps/o

infection

somn/o

sleep

son/o

sound

the/o

put, place

thyr/o

thyroid gland

top/o

place, position

tox/o

poison

trache/o

trachea (wind pipe)

urethr/o

urethra

ven/o

vein

-blast

embryonic, immature cell

-crine

secrete

-cyesis

pregnancy

-drome

to run

-fusion

to come together

-gen

substance that produces

-lapse

slide, fall, sag

-lysis

breakdown, seperation

-meter

measure

-mission

send

-or

one who

-partum

birth, labor

-phoria

feeling

-physis

to grow

-plasia

formation, development

-plasm

formation, structure

-pnea

breathing

-ptosis

falling, drooping

-rrhea

flow, discharge

-stasis

stopping, controlling

-trophy

nourishment, development (condition)

a-, an-

no, not, without

ab-

away from

ad-

toward

ana-

apart, backward

ante-

before

anti-

against

auto-

self, own

brady-

slow

cata-

down

con-

together, with

contra-

against, opposite

de-

lack of

dia-

complete, through

dys-

painful, difficult

ec-, ecto-

out, outside

en-, endo-

within

epi-

above, upon

eu-

good, normal

ex-

away from

hemi-

half

hyper-

above, excessive, increase

hypo-

deficient, below, decrease

in-

in, into

intra-

within, into

inter-

between

macro-

large

meta-

change

micro-

small

para-

near, beside

per-

through

peri-

surrounding

poly-

many, much

post-

after, behind

supra-

above, upper

syn-, sym-

together, with

tachy-

fast

trans-

across, through

co-payment

the amount the insured has to pay toward the amount allowed by the insurance company for services.

capitation

a form of prepayment in which a provider agrees to furnish services to members of a particular insurance program for a fixed fee.

third party payer

a carrier that has an agreement with an individual or organization to provide health care benefits.

co-morbidity

an ongoing condition that exists with another condition for which the patient is receiving treatment.

modality

any physical agent applied to produce therapeutic changes to biological tissue.

superbill

a form listing the most frequently used diagnosis and procedure codes.

HIPAA

Health Insurance Portability and Accountability Act.

cross references

directions to look in another area for the correct code.

rubric

3-digit root code for the classification of illness, disease or injury.

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