CARC
Deductible amount
What is CARC 1
Claim Adjustment Reason Code
What is CARC
Lab-General
What is REV code 300
Pays a percentage of billed charges
What is Percent of Charges
When a patient has a separate E/M service along with a procedure or other service on the same day by the same provider.
What is modifier 25
Duplicate
National Drug Code
What is NDC
IV Therapy-General
What is REV code 260
Payment determined by a pre-established rate per DRG case
What is Per Case
To indicate a procedure was bilateral
What is modifier 50
These are non-non covered services because this is not deemed a 'medical necessity' by the payer
What is CARC 50
Health Insurance Portability and Accountability Act
What is HIPPA
Radiology-General
What is REV code 320
Payment determined by a pre-established per day rate by REV code
What is Per Diem
Multiple procedures
What is modifier 51
The impact of prior payer(s) adjudication including payments and/or adjustments
What is CARC 23
All Patient Refined Diagnosis Related Grouping
What is APRDRG
ER- General
What is REV code 450
Payment determined by using a base amount times a weight assigned to the DRG per CMS
What is CMS DRG
CRNA medically directed by an MD for anesthesia
What is modifier QX
What is CARC 27
Subjective, Objective, Assessment, Plan
What is SOAP
Cardiology-general
What is REV code 480
Payment determined by multiplying a base amount by a weight value based on an All Payment Refined DRG.
What is APRDRG
Professional component only
What is modifier 26