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  2. Healthcare Common Procedure Coding System - Wikipedia

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

    The Health Insurance Portability and Accountability Act of 1996 (HIPAA) instructed CMS to adopt a standard coding systems for reporting medical transactions. The use of Level III codes was discontinued on December 31, 2003, in order to adhere to consistent coding standards.

  3. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    Insurance policies often include specific guidelines regarding covered procedures and exclusions, and these rules can change annually. To avoid billing complications, it is critical for the healthcare provider to stay informed about the most recent coverage requirements for each insurance plan. Step 3: Assigning Codes [4]

  4. Current Procedural Terminology - Wikipedia

    en.wikipedia.org/wiki/Current_Procedural_Terminology

    It is necessary for most users of the CPT code (principally providers of services) to pay license fees for access to the code. [19] In the past, AMA offered a limited search of the CPT manual for personal, non-commercial use on its web site. [20] CPT codes can be looked up on the AAPC (American Academy of Professional Coders) website. [21]

  5. Evaluation and Management Coding - Wikipedia

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

    Evaluation and management coding (commonly known as E/M coding or E&M coding) is a medical coding process in support of medical billing.Practicing health care providers in the United States must use E/M coding to be reimbursed by Medicare, Medicaid programs, or private insurance for patient encounters.

  6. Insurance Services Office - Wikipedia

    en.wikipedia.org/wiki/Insurance_Services_Office

    ISO was formed in 1971 as an advisory and rating organization for the property/casualty insurance industry to provide statistical and actuarial services, to develop insurance programs, and to assist insurance companies in meeting state regulatory requirements. [4] It became a wholly owned subsidiary of Verisk Analytics in October 2009. [5]

  7. National Provider Identifier - Wikipedia

    en.wikipedia.org/wiki/National_Provider_Identifier

    A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The NPI has replaced the Unique Physician Identification Number (UPIN) as the required identifier for Medicare services, and is used by other payers ...

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