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Dual-eligible beneficiaries ( Medicare dual eligibles or "duals") refers to those qualifying for both Medicare and Medicaid benefits. In the United States, approximately 9.2 million people are eligible for "dual" status. [ 1][ 2] Dual-eligibles make up 14% of Medicaid enrollment, yet they are responsible for approximately 36% of Medicaid ...
Major Diagnostic Category. The Major Diagnostic Categories (MDC) are formed by dividing all possible principal diagnoses (from ICD-9-CM) into 25 mutually exclusive diagnosis areas. MDC codes, like diagnosis-related group (DRG) codes, are primarily a claims and administrative data element unique to the United States medical care reimbursement ...
The acronym HCPCS originally stood for HCFA Common Procedure Coding System, a medical billing process used by the Centers for Medicare and Medicaid Services (CMS). Prior to 2001, CMS was known as the Health Care Financing Administration (HCFA). HCPCS was established in 1978 to provide a standardized coding system for describing the specific ...
Summary. Medicare Advantage plans are available in all 50 states and Washington D.C. Medicare-approved private insurance companies provide these plans. These insurance companies must follow ...
Diagnostic colonoscopies are generally covered at 80% on Medicare after the deductible is met. Some Medicare Advantage policies provide less expensive diagnostic colonoscopy coverage than ...
OBD-II PIDs ( On-board diagnostics Parameter IDs) are codes used to request data from a vehicle, used as a diagnostic tool. SAE standard J1979 defines many OBD-II PIDs. All on-road vehicles and trucks sold in North America are required to support a subset of these codes, primarily for state mandated emissions inspections.
The Current Procedural Terminology ( CPT) code set is a procedural code set developed by the American Medical Association (AMA). It is maintained by the CPT Editorial Panel. [ 1] The CPT code set describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among ...
EPSDT. Early and Periodic Screening, Diagnostic and Treatment ( EPSDT) is the child health component of Medicaid. Federal statutes and regulations state that children under age 21 who are enrolled in Medicaid are entitled to EPSDT benefits and that States must cover a broad array of preventive and treatment services.