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Intro Medical Coding

Billing & Coding

QuestionAnswer
Intentional deception or misrepresentation that an individual knows to be false, result in unauthorized benefits to themselves Fraud
Physician & Healthcare Facilities that render health services Providers
Refers to every service listed in the Medicare Physician's Fee Schedule; the same for all physicians as of 1993 Limiting Charge
Adjudication
Composed of numbers and/or letters identifying diagnosis & clinical procedures on claims and encounter forms Code Sets
Patient health record found within a practice management program Electronic Medical Record
This term refers to submitting additional services on a claim that were not performedCo Upcoding
An official publication of all national government changes, especially related to Medicare Federal Register
Reflects physician charges for all procedures provided and/or ordered with offsite facilities Physician Fee Schedule
Used to identify potential discount limit and reflects additional and/or updated procedures Modifier
Considered Hospital Insurance Medicare Part A
Considered Outpatient Insurance Medicare Part B
Formerly considered Medicare + Choice Medicare Part C
Provides prescription drug benefits for Medicare patients Medicare Part D
When was the Medicare Program created The year of 1965
Created by: dorcia.dunn
 

 



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