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Ch 6 - Vocabulary


NP New Patient: An individual who has not received any professional services from the physician or another physician of the same specialty who belongs to the same group practice within the past 3 years.
EST PT Established Patient: An individual who has received professional services within the past 3 years from the physician or another physician of the same specialty who belongs to the same group practice.
DME Durable Medical Equipment: Medical supplies, devices, and equipment.
E/M Evaluation and Management Service: Any diagnostic and therapeutic procedure that may be performed by a health care provider at a specific location.
CPT Current Procedural Terminology: A reference procedural code book using a five-digit numerical system to identify and code procedures established by the American Medical Association.
HCPCS Healthcare Common Procedure Coding System: The CMS's Common Procedure Coding Sytem. A three-tier national uniform coding system developed by the Centers for Medicare and Medicaid Services (CMS), formerly HCFA.
Professional Componets That portion of a test or procedure (containing both a professional and technical component) which the physician performs.
Technical Components Portion of a test or procedure (containing both a technical and a professional component) that pertains to the use of the equipment and the operator who performs it.
Surgical Package Surgical procedure code numbers include the operation; local infiltration, digital block, or topical anesthesia; and normal, uncomplicated postoperative care. This is referred to as a package, and one fee covers the whole package.
Unbundling The practice of using numerous CPT codes to identify procedures normally covered by a single code.
Upcoding Deliberate manipulation of CPT codes for increased payment.
Modifier In CPT coding, a two-digit add-on number placed after the usual procedure code number to indicate a procedure or service has been altered by specific circumstances.
Created by: RacheleCarter