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This process can prevent duplication of insurance payments
What is coordination of benefits
The subscriber
The person whose name the insurance is carried under
This occurs yearly with CPT manuals
What is updating
2 codes
What is the number of codes required for giving a patient an injection of a vaccine
The symbol that appears next to codes that are new since the last CPT revision
What is a red dot
This is authorization that directs an insurance carrier to pay the medical provider or practice directly
What is assignment of benefits
This is the term for the annual cost for healthcare insurance paid by the insured person
What is the premium
This occurs when an insurance claim is submitted with a diagnosis code and a procedure code that are not linked together
What is a claims denial
This is the term used when a diagnosis code verifies the procedure that was justified for the diagnosis
What is medically necessary
Any code that includes more than one procedure in its description
What is bundled
A person who is blind or has a serious long-term disability can qualify for this
What is Medicare?
This has to happen for a person to be eligible for Medicare Part B
What is to enroll
The period of time that is covered for follow up care after surgey
What is the global period
You should start here when you are attempting to locate a code in the CPT manual
What is the alpha index
By Condition
What is how is the Alphabetic Index for ICD-10-CM organized
Check the diagnosis in the Alpha Index
What is the first step in locating an ICD code
This is the term used when both parents have health insurance to determine which plan pays first
What is the birthday rule
WHO
What is the name of the organization that maintains and updates the ICD system
A formulary
What is the list of drugs approved for use by an insurance company
This is the term for the process of checking with an insurance company to see if a patient has an active health insurance plan
What is eligibility verificaiton
This is how most HMO providers are paid for their patients
What is at a capitated rate?
A connection between the diagnostic and procedural indormation
What is code linkage
The code that is used when discussing risk factor reduction and behavior change intervention with a patient
What are the counseling codes
This is an act of deception that is used to take advantage of another person or entitiy
What is fraud
The term for a procedure that is planned in advance and can be done at the convenience of the surgeon and the patient
What is an elective procedure