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Anatomy & Physiology Terminology
Billing Terminology
ICD-10-CM Format and Conventions
Modifiers
ICD-10-PCS
100
Bleeding, Blood Loss
Hemorrhage
100

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

100

This Alphabetic index abbreviation is the equivalent of unspecified.

 NOS (Not otherwise specified)

100

Increased Procedural Services

What is modifier 22?

100

All ICD-10-PCS codes have how many characters?

7-Seven

200
Inflammation of liver
Hepatitis
200

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)

200

This Alphabetic index abbreviation ______, stands for "Not elsewhere classifiable"

NEC

200

Staged or related procedure or service by the same physician or other qualified healthcare professional during the postoperative period.

What is modifier 58?

200

Which character of an ICD-10-PCS code identifies the section and describes the category where the code is located?

1st (First)

300
The study of disease
Pathology
300

A claim received by an insurance payer that is free from errors and processed is a timely manner.

Clean (Claim)

300

The letter ___ is a placeholder in the ICD-10 CM.

X

300

Repeat procedure by another physician or other qualified healthcare professional.

What is modifier 77?

300

This root operation means altering the route or passage of the contents of a tubular body part.

Bypass

400
Right sided paralysis
Hemiplegia
400

A type of insurance arrangement between the payer and the patient that divides the payment for medical services by percentage

Co-Insurance

400

A word that should be interpreted to mean either "and" or "or" when it appears in a title.

And

400

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?

400

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

500
The brain disorder marked by gradual and progressive mental deterioration, personality changes, and impairment of daily function
Alzheimer Disease (AD)
500

A Medicare representative who processes Medicare claims.

FISCAL INTERMEDIARY (FI)

500

This punctuation is used in the Tabular List to enclose synonyms, alternative wording or explanatory phrases.

Brackets [ ]

500

Unrelated procedure or service by the same physician or other qualified healthcare professional during the postoperative period.

What is modifier 79?

500

This root operation is used when stopping, or attempting to stop, postprocedural or other acute bleeding.

Control