System of Medicare reimbursement for HMOs with risk contracts in which enrollees are classified into various DCGs on the basis of each beneficiary’s prior 12-month hospitalization history.

Coding that is inappropriately altered to obtain a higher payment rate. Also known as coding creep, DRG creep , or upcoding .

Procedures used to find the nature and underlying cause of an illness, disease, or condition.

Mechanical or machine laboratory tests that are necessary to identify a disease, syndrome, or condition (e.g., electrocardiograph, electroencephalograph, complete blood count, urinalysis).

Procedures, tests, and examination (scientific evaluation of history, physical signs, symptoms) done on a patient to identify a disease, syndrome, or condition.

Procedure performed that provides information about a known problem or looks for disease after an illness is suspected.

Radiographic and other related studies and procedures performed to identify a disease, syndrome, or injury including portable x-ray services.

Solution used in dialysis to remove excess fluids and waste products from the blood. Also called dialysate fluid .