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123 terms

Billing & Coding week 4

Billing & Coding week 4 medical terms
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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
bi-
two
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
mal-
bad
meta-
change
micro-
small
neo-
new
pan-
all
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.