Heart Murmur

Unbundling

The practice of using numberous CPT codes to identify procedures normally covered by a single code; also known as itemizing, fragmented billing, exploding, or a la carte medicine; billing under Medicare Part B for nonphysician services to hospital inpatients furnished to the hospital by an outside supplier or another provider. 
(The process of coding multiple codes to describe multiple services using one code.)

Modifier

In CPT coding, a two-digit add-on number placed after the usual procedure code number to indicate a procedure or service has been altered by specific circumstances. 
( a two digit character that is appended to a CPT code to report special circumstances involved with a procedure or service)

Relative Value Unit (RVU)

A monetary value assigned to each service on the basis of the amount of physician work, practice expenses, and cost of professional liability insurance. These three RVUs are then adjusted according to geographic area and used in a formula to determine Medicare fees.

Consultation

Services rendered by a physician whose opinion or advice is requested by another physician or agency in the evaluation or treatment of a patient's illness or suspected problem.

Medical Necessity

The performance of services and procedures that are consistent with the diagnosis in accordance with standards of good medical practice, performed at the proper level, and provided in the most appropriate setting

Surgical package -combination of services included in a single procedure code.

medicare

nationwide health insurance program for persons age 65 & older, certain disabled, blind regardless of income. Local SS offices take applications & supply information about the program

benefit period begins the day a patient enters a hospital and ends when the patient has not been a bed patient in any hospital

nursing facility offers nursing or rehabilitation services that are medically necessary to a patient’s recovery.

Respite care is a short-term...