medical

Eponym

A disease, structure, operation, or procedure named after the person who discovered or described it first. Examples include Alzheimer's disease, Parkinson's disease, and Cesarean section.

Acronym

A word formed from the initial letters of a group of words. Examples include MRI (magnetic resonance imaging) and AIDS (acquired immunodeficiency syndrome).

Prefix

A word element placed before a root to modify its meaning. Examples include 'hyper-' (excessive) in hypertension and 'hypo-' (deficient) in hypothyroidism.

Suffix

A word element placed after a root to modify its meaning. Examples include '-itis' (inflammation) in arthritis and '-ectomy' (surgical removal) in appendectomy.

Root

The main part of a word that provides the essential meaning. Examples include 'cardi' in cardiology and 'gastr' in gastroenterology.

Combining Vowel

A vowel (usually 'o') used to link a root to another root or to a suffix, making the word easier to pronounce. For example, in 'gastroenterology,' 'o' is used to combine 'gastr' (stomach) and 'enter' (intestine).

Medical Coding

The process of assigning codes to diagnoses, procedures, and services for billing and data collection purposes. Common coding systems include ICD, CPT, and HCPCS.

ICD (International Classification of Diseases)

A coding system used to classify and code diagnoses. It provides a standardized way to report diseases and health conditions.

CPT (Current Procedural Terminology)

A coding system used to code medical, surgical, and diagnostic procedures and services. It is maintained by the American Medical Association (AMA).

HCPCS (Healthcare Common Procedure Coding System)

A standardized coding system used to identify medical procedures, services, and supplies. It is based on the CPT coding system but includes additional codes for non-physician services and supplies.

Modifier

A two-digit code added to a CPT or HCPCS code to provide additional information about the procedure or service. Modifiers can indicate that a service was altered or performed by more than one provider.

Compliance

Adhering to laws, regulations, guidelines, and ethical standards related to medical coding and billing practices. Compliance programs help prevent fraud and abuse.

Auditing

The process of reviewing medical records and coding practices to ensure accuracy, completeness, and compliance with coding guidelines and regulations. Audits can be internal or external.

Abstracting

The process of reviewing patient medical records to identify relevant information needed for coding and billing purposes. Abstracting involves extracting diagnoses, procedures, and services from the medical record.

Nomenclature

A system of naming things, especially in a particular science or art.

Charge

The amount charged for a medical service or supply.

Claim

A request for payment that is submitted to an insurance company or payer.

Patient

The individual or entity who receives medical services and is responsible for payment.

Provider

A healthcare provider, such as a physician, hospital, or clinic.

Quality Assurance

The process of verifying the accuracy and completeness of coding and billing practices.

Claims Follow-Up

The process of following up on unpaid claims to ensure timely reimbursement.

Denial

A denial of payment by an insurance company or payer.

Appeal

A formal request for reconsideration of a denied claim.

Health Insurance

Insurance coverage for medical expenses, typically provided by a government or private entity.

A fixed amount that a patient pays for medical services at