Form or section of a form that an insurance applicant completes to verify his or her own and dependents’ health so that they can obtain membership in a managed care plan or become insured by an insurance company.

Statistical measurement of a certain individual’s or population’s health based on the individual’s or population’s own assessment; the incidence or prevalence of illness; or mortality and morbidity tables.

All medical services, functions, and resources within a geographical region that exist to affect the state of the health of that given population.

Attempts by the U.S. government to enact legislation to assist in reducing medical costs, increase access of health care, and establish a national health insurance program. Formerly known as health care reform .

Agency funded by the federal government and states to provide services that include health planning, resource development, monitoring, education, and information for the population of a certain region within a state.

Three-tier coding system developed by the Centers for Medicare and Medicaid Services (CMS), formerly the Health Care Financing Administration (HCFA), used for reporting physician/supplier services and procedures. Providers must use HCPCS to receive payment by Medicare and Medicaid programs. Level I consists of national codes to code ambulatory, laboratory, radiology, and other diagnostic services for Medicare billing. This level contains only the American Medical Association’s CPT codes. Level II consists of HCPCS national codes used to report ambulance services, durable medical equipment, and orthotic and prosthetic devices. Level III HCPCS regional/local codes have been discontinued. Pronounced “hick-picks” and formerly referred to as Health Care Financing Administration Common Procedure Coding System (HCPCS) . Also known as national codes .

In HCPCS Level II coding, two alpha digits, two alphanumerical characters, or a single alpha digit placed after the usual five-digit CPT procedure code number. These modifiers are used to identify situations that change the description of service or supply. They are accepted by insurance carriers nationally and are updated annually by the Centers for Medicare and Medicaid Services (CMS) (see Box H-2 and Figure H-1 ).Box H-2HCPCS MODIFIERSWhen taking x-ray films of both feet, the billing portion of the insurance claim appears as follows:05/06/XX73620 RT Radiologic examination, foot—right05/06/XX73620 LT Radiologic examination, foot—left HCPCS Level II alpha modifiers (LT and RT used to identify left and right hands) and alphanumerical modifiers (FA through F9) used to identify digits (fingers) of left and right hands.