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Vocabulary

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Term
Definition
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.  
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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.  
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DME   Durable Medical Equipment: Medical supplies, devices, and equipment.  
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E/M   Evaluation and Management Service: Any diagnostic and therapeutic procedure that may be performed by a health care provider at a specific location.  
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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.  
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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.  
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Professional Componets   That portion of a test or procedure (containing both a professional and technical component) which the physician performs.  
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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.  
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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.  
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Unbundling   The practice of using numerous CPT codes to identify procedures normally covered by a single code.  
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Upcoding   Deliberate manipulation of CPT codes for increased payment.  
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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.  
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Created by: RacheleCarter
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