1. HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating an integrated mental health and mental retardation/developmentally disabled program. This modifier may be required for state Medicaid programs, so check with your state guidelines. 2. Medicare Part A; see hospital insurance .
Tag: MEDICAL
HIAA
Abbreviation for Health Insurance Association of America, which is now known as America’s Health Insurance Plans (AHIP) . See America’s Health Insurance Plans (AHIP) .
hierarchical condition categories (HCC) model
Risk adjustment prospective payment system used by Centers for Medicare and Medicaid Services (CMS) for managed care organizations (MCOs). It uses a hierarchical diagnosis classification system and other demographic adjusters to foretell costs and establish payment amounts for managed care services to Medicare beneficiaries.
Hierarchy
Numerical order of diagnostic codes in which each digit beyond three digits adds information. See Box H-3 .Box H-3ALPHANUMERICAL CODES FOR ICD-10-CMFRACTURE OF UPPER LIMB (810-819)810 Fracture of clavicleIncludes: collar boneinterligamentous part of clavicleThe following fifth-digit subclassification is for use with category 810:0 unspecified partClavicle NOS1 sternal end of clavicle2 shaft of clavicle3 acromial end of clavicle 810.0ICD-10-CMS42.00 Closed fracture of clavicleS42.001 Closed fracture of right clavicleS42.002 Closed fracture of left clavicleS42.009 Closed fracture of clavicle, unspecified side
high complexity (HC)
Phrase used to describe a type of medical decision making when a patient is seen for an E/M service.
High risk
A high chance of loss.
High-cost alternative
See: assumptions .
high-deductible health plan (HDHP)
Health plan that, when combined with a health savings account (HAS) or a health reimbursement arrangement (HRA), provides insurance coverage and a tax-advantage means to help consumers save for future medical expenses. This is a part of the Medicare Advantage Law of 2003.
High-flux hemodiafiltration
See: hemodiafiltration .
High-low commission scale
Insurance payment schedule that gives individuals who sell insurance information that shows the amount of a high first-year commission and the reduced amounts for renewal commissions.