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CertReview1 3/10
Quiz 1
| Term | Definition |
|---|---|
| Evaluation and Management | 99201-99499 |
| Anesthesia | 00100-01999, 99100-99140 |
| Surgery | 10021-69990 |
| Radiology | 70010-79999 |
| Pathology and Laboratory | 80047-89398 |
| Medicine (excluding Anesthesia) | 90281-99199, 99500-99607 |
| abstracting | The extraction of specific data from a medical record, often for use in external database, such as a cancer registry |
| abuse | Practices that directly or indirectly result in unnecessary costs to the Medicare program |
| account number | Number that identifies specific episode of care, date of service, or patient |
| accounts receivable department | Department that keeps track of what third-party payer the provider is waiting to hear from and what patients are due to make a payment |
| activity/status date | Indicates the most recent activity of an item |
| actual charge | The amount the provider charges for the health care service |
| Administration Simplification Compliance Act (ASCA) | Specifically prohibits any payment by Medicare for services or medically necessary supplies that are not submitted electronically |
| administrative services only (ASO) contract | Contract between employers and private insurers under which employers fund the plans themselves, and the private insurers administer the plans for the employer |
| Advanced Beneficiary Notice of Noncoverage | Form provided if a provider believes that a service may be declined because Medicare might consider it unnecessary |
| aging report | Measures the outstanding balances in each account |
| allowable charge | The amount an insurer will accept as full payment, minus applicable cost sharing |
| APC grouper | Helps coders determine the appropriate ambulatory payment classification (APC) for an outpatient encounter |
| assignment of benefits | Contract in which the provider directly bills the payer and accepts the allowable charge |
| auditing | Review of claims for accuracy and completeness |
Created by:
sbogle
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