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  2. Current Procedural Terminology - Wikipedia

    en.wikipedia.org/wiki/Current_Procedural_Terminology

    (4000F–4563F) Therapeutic, preventive or other interventions (5005F–5250F) Follow-up or other outcomes (6005F–6150F) Patient safety (7010F–7025F) Structural measures (9001F–9007F) Non-measure claims-based reporting; CPT II codes are billed in the procedure code field, just as CPT Category I codes are billed.

  3. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    The process begins when a physician documents a patient's visit, including the diagnoses, treatments, and prescribed medications or recommended procedures. [4] This information is translated into standardized codes through medical coding, using the appropriate coding systems such as ICD-10-CM and Current Procedural Terminology (CPT). A medical ...

  4. Procedure code - Wikipedia

    en.wikipedia.org/wiki/Procedure_code

    Healthcare Common Procedure Coding System (including Current Procedural Terminology) (for outpatient use; used in United States) ICD-10 Procedure Coding System (ICD-10-PCS) (for inpatient use; used in United States) ICD-9-CM Volume 3 (subset of ICD-9-CM) (formerly used in United States prior to the introduction of the ICD-10-PCS)

  5. ICD-10 Procedure Coding System - Wikipedia

    en.wikipedia.org/wiki/ICD-10_Procedure_Coding_System

    The ICD-10 Procedure Coding System (ICD-10-PCS) is a US system of medical classification used for procedural coding.The Centers for Medicare and Medicaid Services, the agency responsible for maintaining the inpatient procedure code set in the U.S., contracted with 3M Health Information Systems in 1995 to design and then develop a procedure classification system to replace Volume 3 of ICD-9-CM.

  6. Clinical Care Classification System - Wikipedia

    en.wikipedia.org/wiki/Clinical_Care...

    The CCC provides a unique framework and coding structure. Used for documenting the plan of care; following the nursing process in all health care settings. [1] The Clinical Care Classification (CCC), previously the Home Health Care Classification (HHCC), was originally created to document nursing care in home health and ambulatory care settings ...

  7. OPCS-4 - Wikipedia

    en.wikipedia.org/wiki/OPCS-4

    Minor changes and coding advice for both ICD-10 and OPCS-4 are disseminated through the ICD-10 and OPCS-4 Classifications Content Changes. Until March 2022 this publication was known as The Coding Clinic, which was initially issued as a printed newsletter. Then, in 2012, the format was switched to a single, compendium-like electronic publication.

  8. Managed care - Wikipedia

    en.wikipedia.org/wiki/Managed_care

    The deductible must be paid in full before any benefits are provided. After the deductible is met, the coinsurance benefits apply. If the PPO plan is an 80% coinsurance plan with a $1,000 deductible, the patient pays 100% of the allowed provider fee up to $1,000. The insurer will pay 80% of the other fees, and the patient will pay the remaining ...

  9. Physician Quality Reporting System - Wikipedia

    en.wikipedia.org/wiki/Physician_Quality...

    The Physician Quality Reporting System (PQRS), formerly known as the Physician Quality Reporting Initiative (PQRI), is a health care quality improvement incentive ...