Videotapes made without the knowledge of the subject; used to investigate suspicious claims in workers’ compensation cases.

Situation in which an organization using a capitated method of payment contracts with other providers on a capitated basis and shares a part of the original capitated premium (e.g., carve out services).

1. Fourth digit of a diagnostic code in ICD-9-CM that further defines a three-digit category such as site, cause, or other characteristics. 2. Division under a category in the Current Procedural Terminology (CPT) code book.

Fifth digit of a diagnostic code in ICD-9-CM that gives further specificity and makes a distinction between a code in a four-digit subcategory.

Additional alpha characters or numbers assigned to a group number for the purpose of identification (e.g., two characters separated by a dash [SA-12345]).

Perceived by the individual only and not evident to the examiner (e.g., pain).

In a workers’ compensation case, symptoms that interfere with the injured worker’s ability to work that cannot be objectively measured and are obtained from the injured worker’s description of symptoms (e.g., pain or emotional symptoms that limit specific activities).

Data that cannot be measured, typically referred to as “symptoms.”

Bill sent by a health care provider to the third-party payer or to the patient.