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Medical Coding
Medical Coding - Chapter 19 Key Terminology
13
Health Care
Professional
01/21/2014

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Term
E/M
Definition
based on the following criteria: the history of the patient, the complexity of the examination, and the degree of difficulty in medical decision making.
Term
modifier
Definition
used in circumstances in which the procedure code does not accurately describe the procedure.
Term
WHO (World Health Organization)
Definition
Publishes the International Classification of Diseases, 9th Revision, Clinical Modification
Term
symbols
Definition
used in the CPT Manual to distinguish changes or give instructions to be used when coding.
Term
procedural coding
Definition
the process of translating a marrative description of procedures into numbers
Term
CPT Manual
Definition
provides a comprehensive list of procedure and service codes
Term
new patient
Definition
one who has never been seen by anyone in the practice of has not been seen by anyone in the practice for more than 3 years
Term
ICD-9-CM
Definition
contains numeric and alphanumeric diagnostic codes
Term
kickback
Definition
an incentive provided by another physician, laboratory, hospital, or pharmaceutical representative for using their services
Term
upcoding
Definition
billing for a service at a higher level than was actually provided
Term
principal diagnoses
Definition
the reason that the patient sought care on a particular date
Term
ICD-10
Definition
contains increased specificity and includes recently discovered or diagnosed diseases
Term
established patient
Definition
one who has been seen within the past 3 years by any practitioner in the practice
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