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  2. Healthcare Common Procedure Coding System - Wikipedia

    en.wikipedia.org/wiki/Healthcare_Common...

    Level III codes, also called local codes, were developed by state Medicaid agencies, Medicare contractors, and private insurers for use in specific programs and jurisdictions. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) instructed CMS to adopt a standard coding systems for reporting medical transactions.

  3. ICD-10-CM - Wikipedia

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

    Under the proposal, the ICD-9-CM code sets would be replaced with the ICD-10-CM code sets, effective October 1, 2013. On April 17, 2012, the Department of Health and Human Services (HHS) published a proposed rule that would delay the compliance date for the ICD-10-CM and PCS by 12 months-from October 1, 2013, to October 1, 2014. [ 4 ]

  4. Resource-based relative value scale - Wikipedia

    en.wikipedia.org/wiki/Resource-based_relative...

    The RUC examines each new code to determine a relative value by comparing the physician work of the new code to the physician work involved in existing codes. The practice expense, determined by the Practice Expense Review Committee, consists of the direct expenses related to supplies and non-physician labor used in providing the service, and ...

  5. Medicare Prescription Drug, Improvement, and Modernization Act

    en.wikipedia.org/wiki/Medicare_Prescription_Drug...

    These programs were known as "Medicare+Choice" or "Part C" plans. Pursuant to the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, the compensation and business practices for insurers that offer these plans changed, and "Medicare+Choice" plans became known as "Medicare Advantage" (MA) plans.

  6. Medical classification - Wikipedia

    en.wikipedia.org/wiki/Medical_classification

    ICD has a hierarchical structure, and coding in this context, is the term applied when representations are assigned to the words they represent. [30] Coding diagnoses and procedures is the assignment of codes from a code set that follows the rules of the underlying classification or other coding guidelines.

  7. Drug utilization review - Wikipedia

    en.wikipedia.org/wiki/Drug_Utilization_Review

    Under the Medicare Prescription Drugs, Improvement and Modernization act of 2003, many beneficiaries will have more access to prescription drugs and may use more of them than they do, so a similar drug utilization review standard is needed to effectively implement the medicare prescription drug benefit. [9]

  8. Does Medicare Cover Substance Use Disorder Treatment? - AOL

    www.aol.com/lifestyle/does-medicare-pay...

    Each part of Medicare covers an aspect of substance use disorder treatment. Read more to learn about the costs and what’s covered.

  9. Evaluation and Management Coding - Wikipedia

    en.wikipedia.org/wiki/Evaluation_and_Management...

    This allows medical service providers to document and bill for reimbursement for services provided. E/M codes are based on the Current Procedural Terminology (CPT) codes established by the American Medical Association (AMA). In 2010, new codes were added to the E/M Coding set, for prolonged services without direct face-to-face contact. [4]