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  2. ANSI 834 Enrollment Implementation Format - Wikipedia

    en.wikipedia.org/wiki/ANSI_834_Enrollment...

    An example layout of an X12 834 Version 005010 file is shown below. Each line starts with a code to identify the type of data that follows, with individual pieces of data separated by an asterisk. The tilde indicates the end of that section.

  3. 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.

  4. Current Procedural Terminology - Wikipedia

    en.wikipedia.org/wiki/Current_Procedural_Terminology

    The CPT code revisions in 2013 were part of a periodic five-year review of codes. Some psychotherapy codes changed numbers, for example 90806 changed to 90834 for individual psychotherapy of a similar duration. Add-on codes were created for the complexity of communication about procedures.

  5. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    Medical coders are responsible for translating healthcare services, diagnoses, and procedures into standardized codes used for billing purposes. These codes ensure that healthcare providers receive accurate reimbursement from insurance companies. On the other hand, medical billing involves using these codes to create and submit claims to ...

  6. Centers for Medicare & Medicaid Services - Wikipedia

    en.wikipedia.org/wiki/Centers_for_Medicare...

    HCFA was renamed the Centers for Medicare and Medicaid Services on July 1, 2001. [9] [11] In 2013, a report by the inspector general found that CMS had paid $23 million in benefits to deceased beneficiaries in 2011. [12] In April 2014, CMS released raw claims data from 2012 that gave a look into what types of doctors billed Medicare the most. [13]

  7. Raleigh-based Mako Medical to pay $2.1M to settle ... - AOL

    www.aol.com/raleigh-lab-testing-company-pay...

    Mako Medical, a Raleigh-based lab-testing company, has agreed to pay the state $2.1 million after state investigators identified unnecessary Medicaid billing for urine drug tests over five years.

  8. HCPCS Level 2 - Wikipedia

    en.wikipedia.org/wiki/HCPCS_Level_2

    Level II codes are composed of a single letter in the range A to V, followed by 4 digits. Level II codes are maintained by the US Centers for Medicare and Medicaid Services (CMS). There is some overlap between HCPCS codes and National Drug Code (NDC) codes, with a subset of NDC codes also in HCPCS, and vice versa. The CMS maintains a crosswalk ...

  9. ICD-10-CM - Wikipedia

    en.wikipedia.org/wiki/ICD-10-CM

    The ICD-10 Clinical Modification (ICD-10-CM) is a set of diagnosis codes used in the United States of America. [1] It was developed by a component of the U.S. Department of Health and Human services, [2] as an adaption of the ICD-10 with authorization from the World Health Organization.