Contract between a policyholder and a third-party payer or government health program to reimburse the policyholder for all or a portion of the cost of medically necessary treatment provided by healthcare professionals.
What is health insurance
100
An order of the court that requires a witness to appear at a particular time and place to testify
What is subpoena
100
HIPAA
What is Health Insurance Portability and Accountability Act of 1996
100
Number of chapters in the Volume 1 Index
What is 17
200
Stands for add-on code.
What is plus sign (+)
200
Person who signs a contract with a health insurance company and who, thus, owns the health insurance policy.
What is policyholder
200
Based on a court decision that establishes a precedent; also called case law.
What is common law
200
NCCI
What is National Correct Coding Initiative
200
This volume contains the Index
What is Volume 2
300
Stands for moderate sedation.
What is bull's eye.
300
A healthcare insurance company that provides coverage.
What is third-party payer.
300
Requires documents to be produced. (ex, patient record)
What is subpoena duces tecum
300
WHO
What is World Health Organization
300
Composed of 3 digit codes representing a single disease or condition.
What are Categories
400
Stands for product approving FDA approval.
What is lightening bolt
400
Documents healthcare services provided to a patient and includes patient demographic data, documentation to support diagnoses and justify treatment provided, and the results of treatment provided.
What is patient or medical record
400
Intentional deception or misrepresentation that could result in an unauthorized payment.
What is fraud
400
CHAMPVA
What is Civilian Health and Medical Program of the Department of Veterans Affairs
400
Provides a 4th digit code (one digit after the decimal point) which is more specific than a category code (3 digit) in terms of causes, site, manifestation of the condition.
What are Subcategories
500
Stands for out-of-numerical sequence code.
What is number/pound sign (#)
500
Documentation submitted to a third-party payer or government program requesting reimbrusement for healthcare services provided.
What is health insurance claim
500
Assigning codes to illegally increase reimbursement.
What is upcoding
500
SCHIP
What is State Children's Health Insurance Program
500
Provides a 5th digit code which gives the highest specificity of description to a condition.