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  2. Healthcare Common Procedure Coding System - Wikipedia

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

    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 ...

  3. Current Procedural Terminology - Wikipedia

    en.wikipedia.org/wiki/Current_Procedural_Terminology

    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 ...

  4. Diagnosis-related group - Wikipedia

    en.wikipedia.org/wiki/Diagnosis-related_group

    Diagnosis-related group. Diagnosis-related group ( DRG) is a system to classify hospital cases into one of originally 467 groups, [1] with the last group (coded as 470 through v24, 999 thereafter) being "Ungroupable". This system of classification was developed as a collaborative project by Robert B Fetter, PhD, of the Yale School of Management ...

  5. ICD-10 Procedure Coding System - Wikipedia

    en.wikipedia.org/wiki/ICD-10_Procedure_Coding_System

    The ICD-10 Procedure Coding System (ICD-10-PCS) is a US system of medical classification used for procedural coding.The Centers for Medicare and Medicaid Services, the agency responsible for maintaining the inpatient procedure code set in the U.S., contracted with 3M Health Information Systems in 1995 to design and then develop a procedure classification system to replace Volume 3 of ICD-9-CM.

  6. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    Medical billing is a payment practice within the United States healthcare system. The process involves the systematic submission and processing of healthcare claims for reimbursement. Once the services are provided, the healthcare provider creates a detailed record of the patient's visit, including the diagnoses, procedures performed, and any ...

  7. Resource-based relative value scale - Wikipedia

    en.wikipedia.org/wiki/Resource-based_relative...

    Resource-based relative value scale ( RBRVS) is a schema used to determine how much money medical providers should be paid. It is partially used by Medicare in the United States and by nearly all health maintenance organizations (HMOs). RBRVS assigns procedures performed by a physician or other medical provider a relative value which is ...

  8. Major Diagnostic Category - Wikipedia

    en.wikipedia.org/wiki/Major_Diagnostic_Category

    Major Diagnostic Category. The Major Diagnostic Categories (MDC) are formed by dividing all possible principal diagnoses (from ICD-9-CM) into 25 mutually exclusive diagnosis areas. MDC codes, like diagnosis-related group (DRG) codes, are primarily a claims and administrative data element unique to the United States medical care reimbursement ...

  9. Evaluation and Management Coding - Wikipedia

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

    Evaluation and Management Coding. 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.