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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. National Correct Coding Initiative - Wikipedia

    en.wikipedia.org/wiki/National_Correct_Coding...

    The National Correct Coding Initiative (NCCI) is a Centers for Medicare & Medicaid Services (CMS) program designed to prevent improper payment of procedures that should not be submitted together. There are two categories of edits:

  4. Diagnosis-related group - Wikipedia

    en.wikipedia.org/wiki/Diagnosis-related_group

    In 1982 the US Congress passed Tax Equity and Fiscal Responsibility Act with provisions to reform Medicare payment, and in 1983, an amendment was passed to use DRGs for Medicare, [7]: 16 with HCFA (now CMS) maintaining the definitions. In 1987, New York state passed legislation instituting DRG-based payments for all non-Medicare patients.

  5. Gynesonics Announces New York Medicaid Coverage for CPT Code ...

    lite.aol.com/tech/story/0022/20241217/9320094.htm

    Dr. Taraneh Shirazian, Director of the Center for Fibroid Care at NYU Langone Health, echoed the significance of this coverage. “New York Medicaid’s decision to cover CPT code 58580 marks a crucial moment for countless women who have previously faced obstacles in accessing minimally invasive fibroid treatment,” she stated.

  6. HCPCS Level 2 - Wikipedia

    en.wikipedia.org/wiki/HCPCS_Level_2

    T-codes (example: T1000): State Medicaid Agency Codes; V-codes (example: V2020): Vision/Hearing Services; There are three important HCPCS Level 2 [4] codes for digital mammograms that often used (G0202, G0204 and G0206). The original mammogram codes (film based mammograms) are CPT codes (77055, 77056, and 77057), so it would be easy to overlook ...

  7. Medicare fraud - Wikipedia

    en.wikipedia.org/wiki/Medicare_fraud

    Jimmy Carter signs Medicare-Medicaid Anti-Fraud and Abuse Amendments into law. The Office of Inspector General for the U.S. Department of Health and Human Services, as mandated by Public Law 95-452 (as amended), is established to protect the integrity of Department of Health and Human Services (HHS) programs, to include Medicare and Medicaid programs, as well as the health and welfare of the ...

  8. 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.

  9. Medical classification - Wikipedia

    en.wikipedia.org/wiki/Medical_classification

    ICD has a hierarchical structure, and coding in this context, is the term applied when representations are assigned to the words they represent. [30] Coding diagnoses and procedures is the assignment of codes from a code set that follows the rules of the underlying classification or other coding guidelines.