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CPT Vocabulary

CPT Terminology

QuestionAnswer
Adjunct Codes Codes used to record additional services.
AMA American Medical Association
Biopsy Removal of a small amount of tissue to determine the extent of a disease or to determine a diagnosis.
Bundling Services Combining lesser services with a major service so that one charge will include the variety of services.
CCI Correct Coding Initiative: Bundling edits created by CMS to combine various component items with a major service or procedure.
CMS Centers for Medicare and Medicaid Services: The federal agency responsible for maintaining and monitoring the Medicare program, beneficiary services, and Medicaid and states operations. (formerly Health Care Financing Administration[HCFA]until 2001)
Comorbidity An ongoing condition that exists with another condition for which the patient is receiving treatment.
CPT Current Procedural Teminology. Nomenclature published by the AMA as a means to describe seravices rendered to a patient through the use of numeric codes.
CPT Code Procedural description with a five-digit identifying code number.
Diagnostic Services Services performed to determine or establish a patient's diagnosis.
E&M Codes Evaluation and managment codes used to report patient visits, consults, hospital care, and so on.
Endoscopic Procedure A procedure performed through an existing orifice with a scope to visualized and abnormality or to determine the extent of a disease.
Global Period Specific time frames assigned to a code by an insurance company before additional payment will be made following a surgical procedure (e.g., 10 days, 90 days)
Global Procedures Major surgical procedures that typically have a follow-up period of 20, 60. 90, or 120 days before you may begin to bill the patient for services related to the original procedure.
HCPCS Healthcare Common Procedure Coding System: A coding system designed by CMS to report patient services that uses codes from CPT and other sources of alphanumeric codes.
HIPAA Health Insurance Portability and Accountability Act: An act passed in 1996 to set standards for electronic health care transactions and to protect the privacy and security of patients' health information.
Major Procedure A package procedure that includes the operation, local infiltration, digital blocks, and follow-up care for a specific number of days.
Medicare Part A A national health insurance program for persons over the age of 65 years and qualified disabled or blind persons regardless of income, administered by CMS to cover the cost of hospitalization and nursing facility charges.
Medicare Part B An elective coverage program offered by CMS for aged and disabled patients to provied benefits for physician and other medical services as part of the Medicare Program. This program has a monthly premium that must be paid by the beneficiary to keep the po
Minor Procedures Services identified by AMA as a starred procedure. For Medicare, these include services with either zero or 10 days of follow-up care.
POS Codes Place-of -service (e.g., office, hospital) codes:A complete list of these codes is found in the introduction sectionof Professional Version of CPT manual.
Ranking Codes Listing services in their order of importance by dates of service and values. Codes are usually ranked by value from highest to lowest charges.
RVU Relative Vaule unit: A method to calculate fees for sevices. A unit is translated into a dollar value using a convesion facto ro dollar multiplier.
Superbill A form designed by a medical practice listing the most frequently used diagnoses and procedure codes.
Therapeutic Services Services performed for treatment of a specific condition.
Unbundling Services Listing services or procedures as separate billable components. Although this practice may generate more revenue, it is often an incorrect reporting technique that could result in an insurance compoany auditin a practice or asking for refunds of paid moni
UPIN Unique Personal Identification Number.
Component Billing Billing for each item or service provided to a patient in accordance with insurance carriers' policies.
Modality Any Physical agent applied to produce therapeutic changes to biologic tissues (e.g., Thermal, acoustic, mechanical).
Created by: koka2k1
 

 



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