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  2. Healthcare Common Procedure Coding System - Wikipedia

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

    Level III codes, also called local codes, were developed by state Medicaid agencies, Medicare contractors, and private insurers for use in specific programs and jurisdictions. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) instructed CMS to adopt a standard coding systems for reporting medical transactions.

  3. 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.

  4. Current Procedural Terminology - Wikipedia

    en.wikipedia.org/wiki/Current_Procedural_Terminology

    [3] [4] CPT coding is similar to ICD-10-CM coding, except that it identifies the services rendered, rather than the diagnosis on the claim. Whilst the ICD-10-PCS codes also contains procedure codes, those are only used in the inpatient setting. [5]

  5. Relative value unit - Wikipedia

    en.wikipedia.org/wiki/Relative_value_unit

    Before RVUs were used, Medicare paid for physician services using "usual, customary and reasonable" rate-setting which led to payment variability. [2] The Omnibus Budget Reconciliation Act of 1989 enacted a Medicare fee schedule, and as of 2010 about 7,000 distinct physician services were listed. [ 2 ]

  6. Nephrostomy - Wikipedia

    en.wikipedia.org/wiki/Nephrostomy

    (B) The pigtail catheter is placed in the dilated calyx. The tube in (A) and the pigtail in (B) are marked with white arrows. [1] A nephrostomy or percutaneous nephrostomy is an artificial opening created between the kidney and the skin which allows for the urinary diversion directly from the upper part of the urinary system (renal pelvis). [2]

  7. Resource-based relative value scale - Wikipedia

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

    Using the 2005 Conversion Factor of $37.90, Medicare paid 1.57 * $37.90 for each 99213 performed, or $59.50. Most specialties charge 200–400% of Medicare rates for their procedures and collect between 50 and 80% of those charges, after contractual adjustments and write-offs. [citation needed]

  8. Gilead Sciences, US government settle patent case over HIV ...

    www.aol.com/news/gilead-sciences-us-government...

    Gilead Sciences and the U.S. government have settled a billion-dollar patent dispute over Gilead's HIV prevention drugs Truvada and Descovy, according to a Wednesday filing in Delaware federal court.

  9. Prospective payment system - Wikipedia

    en.wikipedia.org/wiki/Prospective_payment_system

    In 2000, CMS changed the reimbursement system for outpatient care at Federally Qualified Health Centers (FQHCs) to include a prospective payment system for Medicaid and Medicare. [2] Under this system, health centers receive a fixed, per-visit payment for any visit by a patient with Medicaid, regardless of the length or intensity of the visit.