Anatomy & Physiology Terminology
The process by which a patient or provider attempts to persuade an insurance payer to pay for more (or, in certain cases, pay for any) of a medical claim.
Appeal
This Alphabetic index abbreviation is the equivalent of unspecified.
NOS (Not otherwise specified)
Increased Procedural Services
What is modifier 22?
All ICD-10-PCS codes have how many characters?
7-Seven
A document attached to a processed claim that explains to the provider and patient which services an insurance company will cover.
EOB (Explanation of benefits)
This Alphabetic index abbreviation ______, stands for "Not elsewhere classifiable"
NEC
Staged or related procedure or service by the same physician or other qualified healthcare professional during the postoperative period.
What is modifier 58?
Which character of an ICD-10-PCS code identifies the section and describes the category where the code is located?
1st (First)
A claim received by an insurance payer that is free from errors and processed is a timely manner.
Clean (Claim)
The letter ___ is a placeholder in the ICD-10 CM.
X
Repeat procedure by another physician or other qualified healthcare professional.
What is modifier 77?
This root operation means altering the route or passage of the contents of a tubular body part.
Bypass
A type of insurance arrangement between the payer and the patient that divides the payment for medical services by percentage
Co-Insurance
A word that should be interpreted to mean either "and" or "or" when it appears in a title.
And
Separate encounter, A service that is distinct because it occurred during a separate encounter. This modifier should only be used to describe separate encounters on the same date of service.
What is modifier XE?
This type of surgical approach means cutting through the skin, mucous membrane, and any other body layers necessary to expose the site of the procedure.
Open
A Medicare representative who processes Medicare claims.
FISCAL INTERMEDIARY (FI)
This punctuation is used in the Tabular List to enclose synonyms, alternative wording or explanatory phrases.
Brackets [ ]
Unrelated procedure or service by the same physician or other qualified healthcare professional during the postoperative period.
What is modifier 79?
This root operation is used when stopping, or attempting to stop, postprocedural or other acute bleeding.
Control