ICD
Pt Encounter & Billing
Pt Encounter & Billing
CPT
CPT & HCPCS
100
a physician’s description of the main reason for a patient’s encounter
What is diagnostic statement
100
—condition that remains after an acute illness or injury
What is Late effect
100
—health plan that covers services not normally covered by a primary plan
What is Supplemental insurance
100
—procedure performed and reported in addition to a primary procedure
What is Add-on code
100
—single code grouping laboratory tests frequently done together
What is Panel
200
—nonessential word or phrase that helps define a code in the ICD-9-CM
What is Supplementary term
200
—patient’s unintentional, harmful reaction to a proper dosage of a drug(2codes)
What is Adverse effect
200
-explains how an insurance policy will pay if more than one policy applies
What is Coordination of benefits (COB)
200
—cover physicians’ services performed to determine the optimum course for patient care
What is E/M codes (evaluation and management codes)
200
—services used to support a diagnosis
What is Ancillary services
300
—typographic techniques or standard practices that provide visual guidelines for understanding printed material
What is Convention
300
—authorization allowing benefits to be paid directly to a provider
What is Assignment of benefits
300
(electronic or paper) is completed by a provider to summarize billing information for a patient’s visit
What is An encounter form
300
—service in which a physician advises a requesting physician about a patient’s condition and care
What is Consultation
300
—reusable physical supplies ordered by the provider for home use
What is Durable medical equipment (DME)
400
—single code that classifies both the etiology and the manifestation of an illness or injury
What is Combination code
400
—additional illness that either affects the primary illness or is also treated during an encounter
What is Coexisting condition
400
—report that lists the diagnoses, services provided, fees, and payments received and due after an encounter
What is Walkout receipt
400
—code used with procedure codes to indicate a patient’s health status
What is Physical status modifier
400
—incorrect billing practice of breaking a panel or package of services/procedures into component parts
What is Unbundling
500
—represents the patient’s major illness or condition for an encounter
What is Primary diagnosis
500
—procedures that ensure billable services are recorded and reported for payment
Charge capture
500
—document a patient signs to guarantee payment when a referral authorization is pending
What is Referral waiver
500
—using a single payment for two or more related procedure codes
What is Bundling
500
—factor documented for various levels of evaluation and management services
What is Key component
M
e
n
u