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9 Cards in this Set

  • Front
  • Back


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


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


*diagnosis related group

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