1. Rules or principles for determining a diagnostic code when using diagnostic code books such as each space, typefaces, indentations, punctuation marks, instructional notes, abbreviations, cross-reference notes, and specific usage of the words and, with, and due to. These rules assist in the selection of correct codes for the diagnoses encountered. Also called coding conventions. 2. Space-saving rule used in the “Index,” which is the last section of the annually published Current Procedural Terminology code book. For example:KneeIncision (of)In this example, the word in parentheses (of) does not appear in the Index, but it is inferred. As another example:PancreasAnesthesia (for procedures on)In this example, because there is no such entity as pancreas anesthesia, the words in parentheses are inferred (i.e., anesthesia for procedures on the pancreas).

Provision in a group insurance policy that allows the insured to convert to an individual insurance policy if and when the group coverage is ever terminated.

1. The dollars and cents amount that is established for one unit as applied to a service rendered. This unit is then used to convert various services/procedures into fee-schedule payment amounts by multiplying the relative value unit by the conversion factor. 2. National multiplier used to convert the relative value units for each procedure into dollar amounts. The CF is announced annually by the Centers for Medicare and Medicaid Services (CMS) for all services paid under the resource-based relative value scale (RBRVS) Medicare Fee Schedule. Sometimes called conversion number or national conversion factor.

Annual percentage change to the Medicare Fee Schedule conversion factor. It is determined by the Congress or the default formula under Volume Performance Standards.

Fund in which unallocated employer contributions are made to a combination plan. Also called side fund.

Individual whose employment has been terminated and is no longer a member of the employer’s group insurance plan but is still able to continue his or her insurance benefits because of eligibility under the Consolidated Omnibus Reconciliation Act of 1985 (COBRA).

Group health plan that permits a member to change his or her insurance coverage (different benefits and rates) to an individual contract without a physical examination. This situation may occur at termination of employment. Also known as conversion privilege or conversion.

1. Right of an individual covered by a group insurance policy to convert to coverage under an individual insurance policy. This can occur when a person leaves the group, benefits are downgraded or terminated for a specific class, or when the group policy is terminated. 2. Right to change insurance coverage in specific situations from one type of policy to another (e.g., individual term insurance to individual whole life insurance). Also known as conversion.
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The right given to an insured person to change insurance without evidence of insurability.

Act of transferring group insurance coverage to an individual insurance policy.