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  2. Clinical coder - Wikipedia

    en.wikipedia.org/wiki/Clinical_coder

    Some medical coders elect to be certified by more than one society. The AAPC offers the following entry-level certifications in the U.S.: Certified Professional Coder (CPC); which tests on most areas of medical coding, and also the Certified Inpatient Coder (CIC) and Certified Outpatient Coder (COC). Both the CPC and COC have apprentice ...

  3. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    Achieving a high clean claims rate is a key metric for measuring the efficiency of the billing cycle. Creation of the claim is where medical billing most directly overlaps with medical coding because billers take the ICD/CPT codes used by the medical coders and creates the claim. Step 6: Monitoring payor Adjudication [4]

  4. Resource-based relative value scale - Wikipedia

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

    A separate committee, the Specialty Society Relative Value Scale Update Committee (RUC), [7] meets three times a year to set new values, [8] determines the Relative Value Units (RVUs) for each new code, and revalues all existing codes at least once every five years. The RUC has 29 members, 23 of whom are appointed by major national medical ...

  5. Current Procedural Terminology - Wikipedia

    en.wikipedia.org/wiki/Current_Procedural_Terminology

    As the AMA decided in April 1960, the Current Medical Terminology (CMT) handbook was first published in June 1962 – 1963 to standardize terminology of the Standard Nomenclature of Diseases and Operations (SNDO) and International Classification of Diseases (ICD), and for the analysis of patient records, and was aided by an IBM computer. [22]

  6. Relative value unit - Wikipedia

    en.wikipedia.org/wiki/Relative_value_unit

    The services are classified under a nomenclature based on the Current Procedural Terminology (CPT) to which the American Medical Association holds intellectual property rights. [2] Each service in the fee schedule is scored under the resource-based relative value scale (RBRVS) to determine a payment.

  7. AAPC (healthcare) - Wikipedia

    en.wikipedia.org/wiki/AAPC_(healthcare)

    AAPC provides training, certification, [9] and other services to individuals and organizations across medical coding, medical billing, auditing, compliance, and practice management. These services include networking events such as medical coding seminars and conferences. [10]

  8. Independent practice association - Wikipedia

    en.wikipedia.org/wiki/Independent_practice...

    Emergency Medical Treatment and Active Labor Act (1986) Health Insurance Portability and Accountability Act (1996) Medicare Prescription Drug, Improvement, and Modernization Act (2003) Patient Safety and Quality Improvement Act (2005) Health Information Technology for Economic and Clinical Health Act (2009) Patient Protection and Affordable ...

  9. Evaluation and Management Coding - Wikipedia

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

    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.

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