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9 Cards in this Set

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ICD-9

Internal classification of Disease


*why test is being ordered


*must be determined by ordering provider

Authenticated Order

Official Signed written order

Recurring Orders/Standing Orders

*medical necessity for spec pt regarding a specific test(s) and spec time interval


*can't exceed medical necessity

CPT codes

*current procedural terminology


*describes and id med services and procedure performed

ABN

Advance Beneficiary Notice


*needs to be filled out before tested


*pt agrees to pay if medicare does not

National and Local Coverage Determinations

*national and local policies w/ additional restrictions

Medicare secondary Payer (MSP)

other insurance coverage by parent, employer, spouse


*questionerre must be filled out each face to face visit

Midicare Clinical Lab Fee Schedule

*hospital labs paid under the CLFS only for some outpatient testing and all non patient/outreach testing


*payment is determined by services and lab charges in geographic area

DRG

*diagnosis related group


*classifying system for patents into groups to determine resources needed to treat and cost of treatment