mod 110 wk 2

Created by jbolduc85 

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accident

an unexpected happening, causing injury traceable to a definite time and place

adjudication

the final determination of the issue involving settelment of an insurance claim

by report (BR)

a report must be submitted with the claim when notation "BR" follows the procedure code description

claim examiner

in industrial cases, a representative of the insurer who autherizes treatment and investigates, evaluates, and negotiates the patient's insurance claim and acts for the company in the settlement of claim

compromise and release

an agreement arrived at, wether in or out of court, for setteling a workers' compensation case after the patienthas been declared permanent and stationary(P&S)

deposition

the process of taking sworn testimony from a witness out of court. This is usually done by an attorney

ergonomic

science and technology that seek to fit the anatomic and physical needs of the worker to the workplace

extraterritorial

state laws effictive outside the state be either specific provision or court decision.

federal employees' compensation act(FECA)

An act instituted in 1908 providing benefits for on-the-job injuries to all federal employees

fee schedule

a list of charges or established allowence for specific medical services and procedures.

injury

In a workers' compensation policy, this term signifies any truma or damage to a body part or disease sustained, arising out of, and in the course of employment, including injury to artifical members and medical braces of all types

insurance adjuster

An individual at the workers' comp insurance carrier overseeing an industrial case, autherizing diagnostic testing and medical treatment, and communication with the provider of medical care.

lein

A claim on the property of another as security for a debt.

medical service order

An authorization given to the physician, either written or verbal, to treat the injured or ill employee

nondisability claim (ND)

A claim for an on-the-job injury that requires medical care but does not result in loss of working time or income

premanent disability (PD)

in illness or injury expected to continue for the lifetime of the injured worker that prevents the person from prefoming the functions of his or her reguar occupation

petition

formal written request commonly used to indicate; also means any request for relief other than an application

sub rosa films

videotapes made without the knowledge of the patient; used to prove insurance fraud against an injured worker

temporary disability

The recovery period after a work-related injury during which the employee is unable to work and condition has not stabilize

third party liability

Tird-party liability exists if an entity is liable to pay the medical cost forinjury, or disability of a person hurt during the performance of his or her occupation and the injury by an entity not connected with the employer

third party subrogation

The legal process by whick an insurance comopany seeks from a third party, who has caused a loss, recovery of the amount paid to the policyholder

waiting period (WP)

for disability insurance, the initial period of the time when as disable individual is not eligible to recieve benifits

work hardening

An individual program of therapy using simulated or real job duties to build up strength

workers' compensation appeal board (WCAB)

The board that handels workers' comp liens and appeals

workers' compensation insurance (WC)

A contract that insures a person against on-the-job injury or illness. The employer pays the premium for his or her employees.

conversion factor

The dollars and cents amount that is established for one unit as applied to a procedure or service renderd

endotracheal anesthesia

is accomplished by insertion of a tube into the nose or mouth, and passing the tube into the trachea for ventilation

anesthesia

...

general anesthesia

...

qualifying circumstance

code is reported in addition to the primary anesthesia procedure colde

physical status modifier

...

-phena

breathing

-centesis

surgical puncture

-plasty

surgical repair

-stomy

new opening

-oma

tumor

-lysis

destruction,seperation,beakdown,loosening

-tomy

incision

-spasm

tension,spam,contraction

-rrhage

bursting forth

-rrhaphy

suture

-rrhexis

rupture

-arche

beginning

-cele

heria, tumor, swelling

-cyst

bladder, sac

-graph

instument of recording

-malacia

softening

-cyte

cell

-kinesia

motion, movement

-pathy

disease

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