Term
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Definition
| Centers for Medicare & Medicaid Services (CMS): The U.S. Department of Health & Human Services agency that primarily administers the federal Medicare and Medicaid programs. |
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Term
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Definition
| Outpatient Code Editor (OCE): Software used by the Medicare fiscal intermediaries for processing outpatient claims. The OCE performs edits of claims data to identify errors, returning a series of edit flags. |
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Term
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Definition
| National Correct Coding Initiative (NCCI) |
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Term
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Definition
| Outpatient Prospective Payment System (OPPS): A prospective payment system is a reimbursement method in which payment is a pre-determined, fixed amount based on a classification system of that service. |
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Term
| Which form is used to bill for services for facilities? |
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Definition
| The UB-04 is used for facility claims. |
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Term
| Which form is used to bill for services for providers/professional services? |
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Definition
| The CMS-1500 is used for provider/professional service claims. |
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Term
|
Definition
| Centers for Medicare & Medicaid Services (CMS): The U.S. Department of Health & Human Services agency that primarily administers the federal Medicare and Medicaid programs. |
|
|
Term
|
Definition
| Outpatient Code Editor (OCE): Software used by the Medicare fiscal intermediaries for processing outpatient claims. The OCE performs edits of claims data to identify errors, returning a series of edit flags. |
|
|
Term
|
Definition
| National Correct Coding Initiative (NCCI) |
|
|
Term
|
Definition
| Outpatient Prospective Payment System (OPPS): A prospective payment system is a reimbursement method in which payment is a pre-determined, fixed amount based on a classification system of that service. |
|
|
Term
| Which form is used to bill for services for facilities? |
|
Definition
| The UB-04 is used for facility claims. |
|
|
Term
| Which form is used to bill for services for providers/professional services? |
|
Definition
| The CMS-1500 is used for provider/professional service claims. |
|
|
