ABC?
Appendix A?
Modifiers
What does DOS stand for?
Date of Service
A nationwide health insurance program for people age 65 years of age and older and certain disabled or blind persons regardless of income?
Medicare
How many digits make up a CPT code?
5 digits
When a patient comes in for a office visit they pay a specific amount for covered services?
Copayment
Appendix B?
Additions, Deletions, Revisions
What does HMO stand for?
Health Maintenance Organization
A requirement of some health insurance plans to obtain permission for a service or procedure before it is done and to see whether the insurance program agrees that it is medically necessary?
Pre-authorization
What does CPT stand for?
Current Procedure Terminology
The policy holder is responsible for a specific amount each year before the policy benefits begin?
Deductible
Appendix C?
E & M Codes, Clinical Examples
What does HCPCS stand for?
Healthcare Common Procedure Coding System
The contract holder covered by an insurance program or managed care plan who either has coverage through his or her place of employment or has purchased coverage directly from the plan or affiliate.
Subscriber
Is the CPT index listed alphabetically or numerically?
Alphabetically
A policy holder is responsible for a percentage of the fees billed for a medical procedure and or service?
Coinsurance
Appendix D
Add-On Codes
What does COB stand for?
Coordination of Benefits
Illnesses or injuries acquired by the patient before enrollment in an insurance plan?
preexisting conditions
What is the purpose of using the Index in the back of the CPT book?
Speeds up location of the term or code
The amount paid for a medical services in a geographic area based on what a providers in the area usually charge for the same services?
Usually, Customary and Reasonable Fees (UCR)
Appendix M?
Deleted CPT Codes
What does POS stand for?
Place of Services
An insurance plan issued to an individual (or his or her dependents); also known as individual contract?
personal insurance
Who Developed CPT codes?
What percentage does Medicare agree to pay to a participating provider?
80%