Current Procedural Terminology (CPT) code that identifies and has a description of a procedure that is rarely provided, unusual, variable, or new and for which a code does not appear in the code book. Such a code typically ends in 99. A report or documentation needs to be submitted with the insurance claim form to explain the procedure in more detail when using an unlisted procedure code.

In a managed care contract, a hospital facility and a managed care plan that work with each other but are not exclusive to each other. Also see married .

Insurance claim transmitted to an insurance carrier that cannot be processed due to missing, certain incomplete, or incorrect information.

In the Medicare program, a beneficiary who receives blood may either restore the blood or pay the provider’s charges for the unrestored blood. Blood is replaced on a pint-for-pint or unit-for-unit basis.

In a workers’ compensation case, injured worker who is not represented by an attorney.

Obligation (amount owed) that is not secured or backed by any form of collateral.