Healthcare Terminology Flashcard

Front

A scale that provides a value to each CPT code based on physician work effort, practice expense, and malpractice expense.

Back

Medical necessity

Front

The two-digit codes added to professional claims to indicate the setting where services were provided.

Back

Place of service codes

Front

Two characters appended to a CPT code to provide additional information about the procedure without changing the meaning of the code.

Back

Advanced beneficiary notice (ABN)

Front

The refusal of a payer to reimburse the healthcare provider for services billed.

Back

Discharged not final billed (DNFB)

Front

A waiver of liability for the patient to sign if the provider deems Medicare will not pay for a service.

Back

Advanced beneficiary notice (ABN)

Front

Database of all billable items, revenue codes, and CPT/HCPCS codes that describe a service provided within a hospital.

Back

Charge capture

Front

The moral principles that govern conduct.

Back

Morals

Front

Legislation stating that providers cannot be paid for referring patients to an organization.

Back

Principlism

Front

An error that occurs when an organization submits a claim for a diagnosis or procedure that is a higher level than what the patient experienced.

Back

Upcoding