Phrase used to describe a type of medical decision-making when a patient is seen for an E/M service. Medical documentation must consist of multiple diagnoses or management options, a moderate amount of data or complexity of data to be reviewed, and a moderate risk of complications and/or morbidity or mortality.

In a workers’ compensation case, pain that would be endurable but would cause marked handicap in the performance of the activity precipitating the pain.

Also called conscious sedation .

In CPT coding of a service or procedure, this is a problem where the risk of morbidity without treatment is moderate. There is moderate risk of mortality without treatment and uncertain prognosis or increased probability of prolonged functional impairment.

Under the Health Insurance Portability and Accountability Act (HIPAA), this is a change adopted by the Secretary, through regulation, to a standard or an implementation specification.

Under this system of calculating summary measures, the actuarial balance is defined as the difference between the arithmetic means of the annual cost rates and the annual income rates, with an adjustment included to account for the offsets to cost that are due to (1) the starting trust fund balance and (2) interest earned on the trust fund.

Rating method in which premiums are based on the average health care costs within a specific geographical region as modified by rating factors such as age and sex that have been filed with the state insurance department.

Third-party payer system in which physicians are paid for a unit of service provided with a set maximum fee for each service.

Ordinary life insurance that has premiums during the first few years (usually 5) that are slightly larger than the rate for term insurance. After that time period, the annual premium is higher.