In workers’ compensation cases, pain that would preclude the activity precipitating the pain.

Word used to describe the level of seriousness of a patient’s medical condition.
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The amount of damage that is (or that may be) inflicted by a loss or catastrophe. Sometimes quantified as a severity rate, which is a ratio relating the amount of loss to values exposed to loss during a specified period.

Adjustment that shows the effect of patient factors on the work needed to deliver a medical service such as severity of illness, comorbidity, and risk of complications.

1. Degree of disease or loss of function and mortality that a patient is experiencing before treatment. Severity of illness is used in the interpretation of performance data of facilities. 2. Variation in patients classified to the same diagnosis related group that includes age, systems involved in illness, stage of disease, complications, and response to treatment.

Percentage analysis of genders (male or female) of insureds within a group.

1. HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating a second opinion ordered by a quality improvement organization (QIO), eligible for reimbursement at 100%. The usual Medicare deductible and/or coinsurance amounts are not applied. 2. See straightforward (SF) .

1. Policy of setting fees equal or slightly below a competitor’s fees. This may tend to maximize profits but will raise medical costs and is generally considered to be unethical. 2. In an employer group’s managed care plan, to price premiums based on the cost of indemnity insurance instead of following community or experience rating standards.