Medicare review Word Scramble
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Question | Answer |
CDT | Current Dental Terminology |
CPT | Level 1 HCPCS Codes |
HCPCS | Healthcare Common Procedure Coding System |
HCPCS | Level 2 codes (also known as national) |
HCPCS | Codes are organinzed by type of service |
Injection | require 1 CPT (for the act of injecting) and 1 HCPCS code (for medicine) |
Modifiers | Two digit code attached to procedure ti indicate alteration to procedure |
Tabular index | Coding index in which procedures are listed in Numerical Order |
Temporary Codes | may remain temporary forever |
Ambulance Service | are only paid if no other transportation was available |
Ambulatory Surgical Center | is a separate business entity, but may be located in hospital |
Ambulatory Surgical Center | fee schedules are decided by Geographical Wage Index |
Balance Billing | when provider attempts to bill patient what Medicare does not allow. (illegal) |
Case Mix | the different types of patients within a health care facility |
DRG | patient in groups according to diagnosis |
DSM | only used by physician to describe mental |
IPPS | Inpatient prospective payment system |
IRVEN | software used for rehabilitation system |
MPFS | formerly RBRVS, what Medicare allows for procedures |
DSM | Diagnostic and Statisticl Manual |
DRG | Diagnosis Related Group |
MPFS | Medicare Physician Fee Schedule |
Nonphysician Providers | must accept assignment |
OASIS | used for patients receiving Home Health Care medical Service |
Per diem | Latin for each day |
RAVEN | software used for skilled nursing facilities |
ABN | Advanced Beneficiary Notice |
ABN | obtained before a procedure that Medicare is likely not cover. |
Benefit Period | begins with fist day of hospitalization and ends when patient has been out for 60 consecutive days after discharge |
coinsurance | must be collected by provider and failure to do so is punishable by fines |
deadline for filing a claim with Medicare | one year from date of service |
General Enrollment Period | held every year from jan 1st to march 31st |
Hospice | program for both inpatient and outpatient care of teminally ill individuals |
Initial Enrollment Period | first seven months after applying or turning 65 |
Limiting Charge | Maximum amount that Nonpar may charge medicare enrollee |
medicare secondary payer (msp) | info must be obtained first time patient is seen |
Medicare fee Schedule | is developed by Medicare Administrative Contractors(MACS) |
Medicare Select | type of Medigap that requires enrollees to use network of providers |
Medicare Summary Notice | monthly statement that clearly lists health insurance info |
Medigap | supplemental Medicare caoverage |
NonPARs | may accept assingment on a claim by claim basis |
Nurse Practitioner | must work with a physician |
private contract | doctor opted out of medicare for two years cannot charge medicare but charge patient whatever they want |
respite care | service offered to provide relief to non-paid family members who take care of terminally ill patient |
roster billing | mass vaccinations, NO donations may be collected |
part a | covers inpatient hospitalization, hospice care, home health facilities, skilled nursing facilities |
part d | prescription drugs |
special enrollment period | must prove you were unable to meet the first two time periods |
Created by:
quece79
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