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The acronym HCPCS originally stood for HCFA Common Procedure Coding System, a medical billing process used by the Centers for Medicare and Medicaid Services (CMS). Prior to 2001, CMS was known as the Health Care Financing Administration (HCFA). HCPCS was established in 1978 to provide a standardized coding system for describing the specific ...
The medical billing process is a process that involves a third party payer, which can be an insurance company or the patient. Medical billing results in claims, which are billing invoices for medical services rendered to patients. The entire procedure involved in this is known as the billing cycle, sometimes referred to as Revenue Cycle Management.
Chargemaster. In the United States, the chargemaster, also known as charge master, or charge description master ( CDM ), is a comprehensive listing of items billable to a hospital patient or a patient's health insurance provider. In practice, it usually contains highly inflated prices at several times that of actual costs to the hospital.
The Current Procedural Terminology ( CPT) code set is a procedural code set developed by the American Medical Association (AMA). It is maintained by the CPT Editorial Panel. [1] The CPT code set describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among ...
The No Surprises Act aimed to prohibit healthcare services from billing patients with “surprise” charges for out-of-network fees. This meant that for various emergency services and for select ...
National coverage determination. A national coverage determination ( NCD) [1] is a United States nationwide determination of whether Medicare will pay for an item or service. [2] It is a form of utilization management and forms a medical guideline on treatment. Medicare coverage is limited to items and services that are considered "reasonable ...
by electronic patient record systems to identify treating health care providers in patient medical records; by the Department of Health and Human Services to cross reference health care providers in fraud and abuse files and other program integrity files; for any other lawful activity requiring individual identification. Signup process
The AAPC, previously known by the full title of the American Academy of Professional Coders, [4] is a professional association for people working in specific areas of administration within healthcare businesses in the United States. [5] AAPC is one of a number of providers who offer services such as certification and training to medical coders ...