Term
| CMS-Centers for Medicare and Medicaid Services |
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Definition
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Definition
| someone whos income falls below FPL-Federal Poverty Levels or are eligible for SSI |
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| submitted when Medicaid Beneficiary has no other coverage |
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| for people 65 and older/Federal Insurance; Established in 1966 |
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| FICA-Federal Insurance Contribution Act |
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Definition
| Federal payroll tax imposed on both employees and employers to fund Social Security and Medicare |
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| How many parts to the Medicare program? |
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Definition
| A=Hospital B=Physicians C=Medicare Advantage Plans D=Prescriptions |
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Term
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Definition
| medical/physicians/outpatient hospital care (original Medicare) |
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Definition
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| the time when a Medicare Beneficiary is eligible for Part A benefits-inpatient hospitalization |
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Term
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Definition
| is always the payer of last resort |
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Definition
| can be filed if beneficiaries are not satisfied with reimbursement amount |
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Definition
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Term
| EFT-Electric Funds Transfer |
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Definition
| funds are electronically transferred |
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Term
| CLIA-Clinical Laboratory Improvement Act |
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Definition
| regulate lab standards (block #23-QIO) |
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Term
| TANF-Temporary Assistance for Needy Families |
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Definition
| formally AFDC(Aid to Families with Dependent Children) |
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Definition
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| provides assistance for qualified aged, disabled and poor |
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Definition
| optional services when federal funding is available IE; disease screening |
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Definition
| automated voice response system; used to verify eligibility |
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Definition
| varies from state to state |
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Term
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Definition
| are legally obligated to pay all or part of expenses for the eligible PT. |
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Term
| Managed Care Organizations |
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Definition
| Balanced Budget Act of 97; expanded private plans to include MCO's |
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Definition
| determining the nature and cause of disease and distinguish the one from another |
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Definition
| death that occurs from disease |
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Definition
| basic foundation for coding & helps assign correct codes |
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Definition
| named after the person who discovered the disease |
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Term
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Definition
| modifies main term describing different sites |
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Definition
| terms in parenthesis; follows the main term |
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| ICD-9, section 2 and volume 2 |
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Definition
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Definition
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Definition
| translating verbal descriptions into numbers and letters |
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| used in Vol 1 to alert the coder to special edits and important issues |
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Term
| "CM" in ICD-9 CM, stands for |
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| used by physicians and outpatient clinics |
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| Two tables in the Alphabet index to Diseases |
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Definition
| hypertension and neoplasm |
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Term
| 3 types of codes in volume 1 of the ICD-9 |
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Definition
3 digit category code
4 digit sub-category code
5 digit sub-classification code |
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Term
| If no specific diagnosis for a PT. |
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Definition
| code the signs and symptoms |
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Term
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Definition
| when multiple diseases are combined, one code can be assigned |
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