CPT-4 definition

CPT-4 means the American Medical Association's “Physicians' Current Procedural Terminology,” fourth edition, as contained in the 1991 edition of “Relative Values for Physicians,” published by SysteMetrics, a subsidiary of McGraw-Hill, Inc., as adopted by reference in section 1 of regulation R193-91, filed with the secretary of state on January 24, 1992.
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Examples of CPT-4 in a sentence

  • The Medical Group's Medical Personnel shall be responsible for providing the appropriate current CPT4 coding with respect to the fee tickets prepared by such Medical Personnel.

  • Current coding methods include: CPT-4 and HCFA Common Procedure Coding System Level II - (HCPCS-II).

  • Physician procedure codes classified by CPT-4 (Common Procedure Terminology, Version 4).

  • The contractor must maintain sufficient reference data (NDC codes, HCPCS, CPT4, Revenue codes, etc.) to accurately process fee for service claims and develop encounter data for transmission to the Department as well as support Department required reporting.

  • Company utilizes nationally recognized coding structures including, but not limited to, Revenue Codes as described by the Uniform Billing Code, AMA Current Procedural Terminology (CPT4), CMS Common Procedure Coding System (HCPCS), Diagnosis Related Groups (DRG), ICD-9 (or successor standard) Diagnosis and Procedure codes, and National Drug Codes (NDC).

  • Claims must be made on HCFA 1500 billing or applicable state forms using CPT-4 and ICD-9 or the most recent diagnostic and procedural coding systems, or a reasonable equivalent containing all necessary information along with a medical report.

  • For physician Provider pool claims a table of unduplicated 24 users, encounters, allowed charges, Contract Rate, charges/Contract Rate per encounter by CPT4 major 25 procedure code groups.

  • A Clean Claim shall contain the following: Participant's name, address, date of birth, social security number, Physician's name and identification number, address, phone number, tax identification number; dates and location of service, description of procedures, diagnosis code (ICD-9-CM), secondary diagnosis code (ICD-9-CM), procedure code (CPT-4), DRG, revenue code, units, modifiers, and amount billed for each procedure, where applicable.

  • Itemized statements on current HCFA 1500 claim forms with current HCPC coding, current ICD9 coding and current CPT4 coding for all Covered Health Services provided by Specialist Physicians must be submitted by Specialist Physician to HMO at the address set forth below within sixty (60) days of the date the Covered Health Service was provided.

  • The subsystem must capture all health care services, including medical supplies, using standard codes (e.g. CPT-4, HCPCS, ICD9-CM, UB92 Revenue Codes), rendered by health-care providers to an eligible enrollee regardless of payment arrangement (e.

Related to CPT-4

  • Database Management System (DBMS) A system of manual procedures and computer programs used to create, store and update the data required to provide Selective Routing and/or Automatic Location Identification for 911 systems. Day: A calendar day unless otherwise specified. Dedicated Transport: UNE transmission path between one of CenturyLink’s Wire Centers or switches and another of CenturyLink’s Wire Centers or switches within the same LATA and State that are dedicated to a particular customer or carrier. Default: A Party’s violation of any material term or condition of the Agreement, or refusal or failure in any material respect to properly perform its obligations under this Agreement, including the failure to make any undisputed payment when due. A Party shall also be deemed in Default upon such Party’s insolvency or the initiation of bankruptcy or receivership proceedings by or against the Party or the failure to obtain or maintain any certification(s) or authorization(s) from the Commission which are necessary or appropriate for a Party to exchange traffic or order any service, facility or arrangement under this Agreement, or notice from the Party that it has ceased doing business in this State or receipt of publicly available information that signifies the Party is no longer doing business in this State.

  • EUA or “Extended Use Agreement” means, with respect to the HC Program, an agreement which sets forth the set-aside requirements and other Development requirements under the HC Program.

  • E-Verify system means an Internet-based system operated by the United States Department of Homeland Security that allows participating employers to electronically verify the employment eligibility of newly hired employees; and

  • Multiple Exchange Carrier Access Billing or “MECAB” means the document prepared by the Billing Committee of the OBF, which functions under the auspices of the Carrier Liaison Committee (CLC) of the Alliance for Telecommunications Industry Solutions (ATIS). The MECAB document, published by ATIS as ATIS/OBF-MECAB- Issue 6, February 1998, contains the recommended guidelines for the billing of access services provided to an IXC by two (2) or more LECs, or by one LEC in two (2) or more states within a single LATA.

  • HCPCS means the Healthcare Common Procedure Coding System.