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A medical classification is used to transform descriptions of medical diagnoses or procedures into standardized statistical code in a process known as clinical coding. Diagnosis classifications list diagnosis codes, w...
Stark Law is a set of United States federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare or Medicaid patient to an entity for the provision of designated health serv...
AAPC provides training, certification, [9] and other services to individuals and organizations across medical coding, medical billing, auditing, compliance, and practice management.
Emergency Medical Treatment and Active Labor ActThe Emergency Medical Treatment and Active Labor Act (EMTALA) [1] is an act of the United States Congress, passed in 1986 as part of the Consolidated Omnibus Budget Reco...
A part of the Federal Balanced Budget Act of 1997 made the Centers for Medicare and Medicaid Services create a new Medicare "Outpatient Prospective Payment System " (OPPS) for hospital outpatient services -analogous t...
The chargemaster may be alternatively referred to as the "charge master", "hospital chargemaster", or the "charge description master" (CDM). [4][5] It is a comprehensive listing of items billable to a hospital patient...
Before the 1992 implementation of the Medicare fee schedule, physician payments were made under the "usual, customary and reasonable" payment model (a "charge-based" payment system). Physician services were largely co...
Case mix groups are used as the basis for the Health Insurance Prospective Payment System (HIPPS) rate codes used by Medicare in its prospective payment systems. [1] Case mix groups are designed to aggregate acute car...
