Glossary

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  • ABN
    Advanced beneficiary notice of noncoverage. This is an official Medicare form, that must be filled out on every visit, to designate that a patient is aware that this service might not or will not will not be paid by Medicare.  
  • Abdomen
    The part of the body lying between the chest and the pelvis, stomach area. This might also include the sides of the belly.  
  • Abuse, billing
    What happens when a third–party carrier, such as Medicare, or a private insurance carrier, is billed for services that are not covered, or are not correctly coded.  
  • Accepts assignment
    When a patient agrees in writing to have the insurance payment come directly to the doctor's office instead of the patient. Very often, patients of preferred or contracted providers must accept assignment because of the terms of the insurance contract.    
  • Accreditation
    A process by which an organization recognizes a program of study, or institution is meeting professional, predetermined standards.  
  • Acquired
    Produced from outside of the body or obtained, not genetic.
  • Active care
    Modes of treatment requiring active involvement, or participation and responsibility by the patient.
  • Activities of daily living
    Daily habits sussed is dressing, eating, bathing, and moving throughout your day. Doctors assess ADLs to determine how much an individual's ability is and ability to function is restricted.  
  • Actual charge
    The amount a provider charges as usual and customary, which may be decreased by an insurance payment agreement or contract.
  • Acupuncture
    A practice in which fine needles are inserted into specific points on meridians or energy lines in the body, and manipulated to produce pain relief or other various effects.
  • Acute
    Of short duration and typically the most severe portion of problem.  
  • Acute conditions
    Conditions are considered acute usually for the first 4 to 8 weeks after the injury or onset of illness. Note also that a "new" episodes of chronic recurrently conditions may be referred to as an "acute episode".
  • Adjustment
    A term used to describe the highly specific process of manipulating of a body part, typically a joint, with a specific intention, such as to restore or normalize or produce an effect. An adjustment may be direct, as in applied to the actual level of interest, or indirect, as in applied to the(...)
  • Adverse Response
    A response to a drug or procedure that is unintended, unwanted, but otherwise as a result of a proper procedure.  
  • Aftercare
    A scheduled visit for a secondary procedure expected to happen in the future, usually planned as a part of a treatment plan.  
  • Aggravation
    A worsening of a pre-existing problem in a way that the degree of permanent impairment is increased.  
  • Algia
    A suffix meaning “pain”, such as “Neuralgia”, or nerve pain
  • Alignment
    The desired orientation or process of establishing an ideal relationship or orientation between two structures such as spinal vertebral bodies.
  • Allowed amount
    The amount a third-party payer (insurance company) determines they will pay for a procedure or service is typically called an "allowed amount". It may be less than a provider's actual charge. It is specific to an insurance carrier, and may be arbitrary.  
  • Anesthesia
    Loss or absence of sensation caused by administration of a drug or a procedure.
  • Ankylosis
    Stiffening or spurring, consolidation, or near – fusion of a joint following surgery, injury, or disease, which can include prolonged, unhealthy motion patterns.  
  • Antalgia
    Pain with movement or position  
  • Antalgic
    An abnormal position or posture of the body where the patient holds themselves to attempt to minimize pain  
  • Anterior
    In the front aspect if the body.
  • Appeals Process
    A legal means by which a doctor or patient may dispute reimbursement or determinations by an insurance company , health committee or other entity  
  • Apportionment
    A calculation distributing fault, blame or causation among multiple factors that may have caused or contributed to an injury disease or existing problem, such as when someone has two motor vehicle accidents, both causing injury. Another example requiring apportionment would be a patient with(...)
  • Approved amount
    The amount of that insurance company agrees to pay or a service to a patient.. Varies from company to company, except in the case of certain specialized icing structures, such as state Worker's Compensation. Occasionally, approved amounts are based on state Worker's Compensation, or Medicare(...)
  • Arthritis
    A common name used for a category of degenerative condition that effects a joint. Rather than a wearing away, the joint typically is afflicted with boney growth, which can effect range of motion and cause stiffness; a condition for which chiropractic treatment, but not all types of(...)
  • Arthro
    A prefix meaning joint  
  • Arthropathy
    The disease of a joint
  • Arthroscopic
    The procedure of arthroscopy in which a camera is inserted into a joint to look for foreign bodies or damage.
  • Articulation
    The movement services of a joint, connection between bones, the joint itself.  
  • Assessment
    Part of the evaluation and management process of care - usually the portion where the doctor makes an appraisal of the extent, duration, and expected outcome of an injury or treatment plan.  
  • Atlas
    The C-1 vertebrae, the topmost bone of the spine, just below the skull. Has important considerations for neurological and circulatory structures, and is often involved in headache patterns related to the spine and the skull base.  
  • Atrophy
    A shrinkage or decreasing the size of a body part, tissue, or organ, often as a function of aging, or disease.  
  • Autoimmune disease
    Autoimmune diseases have many manifestations, and typically cross different specialties, such as rheumatology, endocrinology, hematology, neurology, cardiology, gastroenterology and dermatology. In common speak, we are describing potential effects on joints, blood, glands, nerves, the heart,(...)
  • Autonomic nervous system
    The part of the nervous system that regulates involuntary actions such as the beating of the heart and the functioning of the glands in the intestines, which is made up of the sympathetic and parasympathetic nervous system.
  • Balance billing
    The procedure when a clinic bills a patient for the remaining amount, after the insurance payer has completed payment, and any required or appropriate right offs have been taken.  
  • Biofeedback
    A technique that enables an individual to gain some voluntary control over otherwise automatic body functions.  
  • Biomechanics
    Literally the application of mechanical laws to living structures, the way things fit together, move, and work
  • Board certified
    Can refer to an additional certification by a licensing board, such as the American Board of chiropractic orthopedics. A postgraduate certification. Most of these certifications require against additional school time, rigorous testing, and additional continuing education  
  • Brace
    An orthopedic device used to hold or align parts of the body for support or protection.  
  • Brainstem
    The oldest and most primitive area of the brain that extends down into the upper cervical area from the base of the skull.  
  • Bundling
    A process by which several CPT service codes are grouped to together by a payor into a single CPT code. May be a typically arbitrary process, used by insurance companies to decrease their costs.  
  • Bursitis
    Inflammation of a bursa, which is a fluid filled sac used to pad a joint. Such as behind the knee, or in the elbow.  
  • Capitation, capitated policy
    A reimbursement system where insurance ,  company pays a predetermined amount for a particular patient, for a particular number of services over a particular number of days.
  • Carrier
    Insurance payer that underwrites or administers health or other insurance programs.
  • Cervical Spine
    The 7 vertetbra of the neck, numbered C1 through C7. Sometimes the base of the skull, or "Occiput" is considered "C0" or C-Zero".  The Cervical spine is just above the Thoracic spine, which is above the Lumbar spine.
  • Claim
    An insurance term, referring to the request for reimbursement of the charges for a procedure to insurance company. May also refer to a request for disability evaluation, or the payment of a benefit such as retirement or Social Security.  
  • Comorbidity / Comorbidities
    A condition that exists at the same time as another problem or diagnosis. It may or may not be directly or indirectly related to the Chief Complaint or "problem at hand". So, for example, osteoarthritis or rheumatoid arthritis could be a comorbidity to consider along with a neck strain from(...)
  • Complementary and Alternative Medicine (CAM)
    A definition that varies widely, it refers to the use of health care approaches outside of "mainstream Western" or "conventional medicine" for specific conditions and overall well-being. Complementary and Alternative refer to different concepts -  Complementary meaning a non-mainstream(...)
  • Cranio-Sacral, Craniosacral
    Originally conceived by an Osteopath, Craniosacral Technique has been applied within Chiropractic treatment plans, complements chiropractic manipulative therapies and has significant implications when added to Wellness Plans. The technique involves manipulating the cerebro-spinal fluid flows(...)
  • Diversified Technique - Diversified technique (DT)
    Diversified Technique - Diversified technique (DT) or simply "Diversified" is considered the most commonly used manipulative technique by chiropractors.[1] Like many chiropractic and osteopathic manipulative techniques, Diversified is characterized by a high velocity low amplitude thrust.(...)
  • Dys
    Dys as in dysfunction, a prefix meaning "abnormal".
  • Dysfunction
    An abnormal function in a system, such as when a joint or a body system is not performing at an ideal level, for one reason or another, including as a result of trauma. This is a recognized the chiropractic diagnosis, or "segmental dysfunction".
  • EMG and electromyography
    A test used to measure muscle contraction, or muscle activity. Often referred to as a "nerve conduction study"  
  • EMS
    Electrical muscle stimulation, which is used to help reduce spasm in a muscle or decrease pain in a body region.  
  • Edema
    A condition in which an area in the body, such as surrounding a joint or in the skin, fills with excessive fluid, creating swelling.  
  • Established patient
    A patient who has previously received professional services from a doctor. Once a patient has seen a doctor, technically that doctor will always have a doctor – patient duty to them. In the insurance billing world, every three years an established patient becomes a new patient once again (if(...)
  • Ethical behavior
    Activities and guidelines for fulfilling responsibilities with integrity and honesty. Moral principles that apply to the practice of healthcare.
  • Etiology
    The cause or origin of a disease.  
  • Evaluation and Management (E/M) -
    Services preformed by a doctor or clinic in order to diagnose, or manage a case for a patient. Examination or re-exam procedures. These are separate from treatment procedures, but every treatment procedure flows from an exam procedure.  
  • Exacerbation
    A temporary worsening of the patient's condition. Typically, this would describe a significant, measurable worsening which might be temporary.  
  • Extension
    Often described as the movement that moves a joint or body part to its farthest length or reach. Also used to describe the movement of the head in looking up towards the sky or, for example, straightening the knee from a bent position.  
  • Extraspinal
    Joint areas not involving the spine or Pelvis.  
  • Facet
    The joint surface of a vertebrae/spinal bone, typically one above and one below.  
  • Fee for Service
    The amount charged for each specific service rendered by a clinic or doctor.  
  • Fee schedule
    A list of fees or amounts allowed or charged for specific health care services.  
  • First Intention
    In treatment, the initial course of treatment chosen to address a problem. In surgery, closing a wound with sutures versus letting it heal on its own (Secondary Intention); using a chiropractic manipulation to resolve a joint problem (First Intention) versus injecting or referring for(...)
  • Fixation
    Being held in a fixed position. In the case of the spine, a joint can have restricted movement, and it can either be fixed, or not fixed. Often, fixation occurs as a result of muscular activity, ligamentous shortening or occasionally scar tissue.  
  • Flexion
    A type of movement described typically as the bending a joint as opposed to opening it up, or for example, in the case of the neck, moving the chin down to the chest. Closing the hand into a fist would be flexing the hand as opposed to opening the fist which is extension of the finger joints.  
  • Foramen
    A small opening or gap, for example where a spinal nerve leaves The spine from in between vertebrae, or A blood vessel Travis into or through a bone.  
  • Fracture
    A disruption, break or rupture in a bone.
  • Fraud
    When a person or provider intentionally deceived or misrepresents something going to be for us or not believe to be true, in order to gain some benefit.  
  • Frontal
    Pertaining to the front  
  • Functional limitation
    Inability to perform some activity, or movement due to an impairment. Inability to extend the arm due to a frozen shoulder, for example, would be a functional limitation.  
  • Gatekeeper
    An insurance term, describing an entity or provider given the responsibility to authorize procedures like x-rays or referrals to a specialist.  
  • HIPAA
    The Health Insurance Portability and Accountability Act. This provides criteria for what can be released from a patient's records, and standards for the ways that records must be stored and protected in order to maintain confidentiality.  
  • Health
    A state of optimal physical, mental and social well-being  
  • Homeostasis
    A state of balance produced by natural systems, such as in a properly functioning organism.  
  • Hyper
    A prefix meaning "over", above normal, or excessive, as in hypertension.
  • Hypermobility
    Excessive movement of a region or joint.  
  • Hypertrophy
    A condition where a region builds up tissue, or over develops, such as when bony spurs increase the size of a joint, potentially blocking movement, or creating compression on a nerve or structure.  
  • Hypo
    A prefix meaning "under", less than normal, or restricted, as in hypoglycemia.  
  • ICD, ICD-9, ICD-10
    The international classification of diseases coding system, 10th revision, which describes the numerical coding system used by doctors and clinics to describe every condition evaluated or treated, including health. The current system is known as ICD-9 and the ICD10 colds are scheduled to go(...)
  • Ilium
    One of the bones that make up each half of the pelvis, the hip joint is present on this phone. This phone is one half of the sacroiliac joint. The S I joint is made up of the sacrum in the ileum on that side.  
  • Immobilization
    A type of supporting or restraining a joint or body part from a portion or all of its normal range of motion, typically temporary, to allow healing or prevent further injury.  
  • Impairment
    The loss of a functional activity, perhaps specifically like bending, or referring to the loss of a body function, such as the ability to stand and walk, or to see. It can refer to the person as a whole, or to a specific function. Impairment is a consideration required determining the severity(...)
  • Incidental Finding
    A finding or additional condition that is noticed but is not related to the problem at hand. For example, when looking at a x-ray, an unrelated bone spur in another area could be an incidental finding to the issue being researched on the x-ray. An incidental finding can still be significant,(...)
  • Independent medical exam, examination
    An evaluation performed by an examiner, who evaluates a diagnosis or a chart, typically for a claims evaluation or Disciplinary reasons, and often performed at the request of a hey your, such as an insurance company. Has also been referred to as a "insurance medical exam" IME.  
  • Independent medical examination (IME)
    Also known as a "insurance medical examination", this is a specific evaluation performed by an independent examiner, who evaluates but does not provide care for the individual, often on the request of a third party.  
  • Indication, Indicate, Indicated
    A term referring to whether or not a particular type of treatment, procedure, medication or next step should be applied to a problem or situation. As in "the use of hot packs is not indicated for heat stroke".  
  • Inferior
    As in inferior to, can refer to lower in position, as in below the elbow.  
  • Inflammation
    A tissue reaction due to injury or disorder, that can produce additional fluid, rise in temperature, swelling, and in creased blood supply in the region.  
  • Inpatient Care
    Extended care given to a patient in a hospital, nursing home, or a medical institution, such as a clinic or an emergency room visit. Distinguishable from "outpatient”. Once "booked into a room", care becomes "inpatient". Typically, inpatient procedures are more complicated or require more(...)
  • Insurance
    A program in which an individual pays a company, to pay for benefits in case a risk occurs. Clients of an insurance company are referred to as "risks". Insurance rates are typically calculated based on how much risk a patient person presents. Insurance is regulated by state and federal(...)
  • Insurer
    A company which underwrites, or takes on a risk for paying for a life, health, or other insurance program. And insurer is taking a chance and extending an insurance policy on the hopes that it's client will not actually become ill or injured. Risks are calculated and change based on many(...)
  • Intensive care
    In the chiropractic contacts, would be the initial intensive care phase of a treatment plan, characterized by frequent visits for the purpose of eliminating or reducing the patients major complaint. In a conventional definition, referring to significant treatment performed in a hospital ward(...)
  • Inter
    In between, as in inter-segmental, as in in between or inside a joint.
  • Interference
    a blockage or decrease in a signal, or function, in chiropractic typically referring to interference of nerve transmission. Some definitions of chiropractic, which are not specifically mainstream,May also refer to "nerve interference".In this case, this might be referring to a "latent signal"(...)
  • Intervertebral
    In between two vertebrae, or levels in the spine. Maybe listed as intra-vertebral.  
  • Intravertebral disc
    A fibrocartilaginous pad between vertebral bodies that acts as a shock absorber, and includes a pokey center the apps as a cushion and a fulcrum. See also intervertebral disc. This may also be incorrectly referred to as "inter vertebral" disk.  
  • Intravertebral foramina / IVF
    The tunnel, or opening through which the spinal nerve roots exit the spinal column which is typically made up of a component of the vertebra below and the vertebra above. These openings are at risk when there are spurs or loss of joint height, as well as a space occupying lesion, like a disc(...)
  • Iontophoresis
    A treat in the gallery using a small electric charge to deliver medicine through the skin, is often used in cases of inflammation, or sometimes to dissolve.    
  • Itis
    A suffix which means inflammation, as in arthritis osteoarthritis.
  • Joint
    Found at the junction between two or more bones, permitting movement. There are different types of joints, including disc joints, joints with fluid in them, or joints that are like flexible straps.  
  • Kyphoscoliosis
    Kyphoscoliosis is a developmental spinal curvature that produces a forward rounding of the thoracic spine  - often created a hunched posture. The degree of the curve is different for all individual cases. The shape that the spinal bones formed in produced this curvature, so while supportive(...)
  • Kyphoscoliosis
    Kyphoscoliosis is a developmental spinal curvature that produces a forward rounding of the thoracic spine  - often created a hunched posture. Can have a normal function in forward bending, but typically restricted in extension backwards.The degree of the curve is different for all individual(...)
  • Kyphosis
    One of the two natural curvatures of the spine, as in kyphosis and lordosis. The kyphosis of the spine is best described where the mid back bends forward, as opposed to the neck curving backwards, and the low back also curbing backwards.  
  • LEIN
    A legal term in which a note is extended, guaranteeing that a doctor or facility retains a portion of a benefit or financial award when services are not being paid at time of service. PAT OS.  
  • Late effect
    The residual effect after an injury has gone beyond its acute phase, or referring to incurring in the period after and as a result of an injury. As in "late effect of strain and sprain".  
  • Lateral
    From the side of the body or structure.  
  • Letter of appeal
    A letter a patient or doctor can write to an insurance carrier or regulatory body like the state, which states that a treatment which may have been denied by insurance, was medically necessary, and then is eligible for performance for payment.  
  • Limiting charge
    A cap on how much a nonparticipating provider may bill Medicare patients.  
  • Lipping
    The development of bony outgrowth in between the vertebrae, often described as "Spurs", because of the way they look on an x-ray.  
  • Listing, Listings, Listing Systems –
    As in spinal listing, referring to a chiropractic concept of various systems used to describe the motion or position of vertebral segments relative to each other. Listing systems may vary from technique to technique, although the day versified diverse a fine dining versified system of(...)
  • Lordosis
    The natural forward curvature of the spine when seen from the side, is in the normal curve of the neck and the normal curve of the low back. See also hypo lordosis.  
  • Lumbar spine
    The five vertebra of the lower back, numbered L1 through L5. The L5 or lowest lumbar vertebra makes up the superior, or top portion, of the lumbosacral region and lumbosacral joint.  
  • MEDIGAP or Medicare Supplemental Insurance
    Health insurance sold by private insurance companies to fill the gaps in original Medicare plan coverage. Varies by state.  
  • MRI / Magnetic Resonance Imaging
    The use of magnetic radio waves to create an image of the structures of the body. MRI can visualize soft tissues as well as bony tissues, and can quantify many descriptive qualities of those tissues. MRI can often be up to or more than 10 times as expensive as x-ray. MRI does not use(...)
  • Maintenance plan, Maintenance Care
    Typically refers to therapy performed to prevent disease, promote health, and prolonged hands the quality of life, or to maintain or prevent deterioration of a chronic condition.  
  • Managed Care
    An Insurance term, referring to a program intended to reduce unnecessary health costs, by controlling the delivery systems and regulating the providers of healthcare via systems such as the gatekeepers. The term "networks" of insurance typically referred to managed-care organizations or MCO's,(...)
  • Manifest, Manifestation
    When the characteristic, signs or symptoms of a problem or illness first appear.
  • Manipulation
    A specific, skill, and deliberate deliberate movements, shift, or application of a physical signal to a joint, soft tissue, Or region of the body, for a specific purpose which is predefined. All manipulations are describable and reproducible, and must be documented as to location, depth, level(...)
  • Manual therapy
    Especially in describing chiropractic, any procedure by which the hands directly contact anywhere on the body for the purposes of providing therapeutic benefit.
  • Massage
    A procedure in which pressure, friction, force, vibration are applied to the body for the purposes of providing therapeutic benefit, which can include relaxation of the region. Massage must be documented including the technique involved the region, the period of time, and the result.  
  • Maximum Medical Improvement (MMI)
    Maximal medical improvement, or maximal chiropractic improvement, or maximum medical/chiropractic improvement or Maximal Chiropractic/Medical improvement. This Refers to the point at which a condition or state is well stabilized and unlikely to change substantially in the next year, with or(...)
  • Maximum therapeutic benefit MTB
    The point at which the status of the condition will not improve beyond a certain level of symptomatology or disability, no matter what treatment or care approach is provided.  
  • Med-pay, Med Pay, Medical Payments Coverage
    An insurance term referring to a portion of a policy that provides benefits to pay for healthcare services rendered for injuries. This is distinct from compensation for permanent injury. Typically is specifically defined inside an insurance policy, and is not required in all automobile or(...)
  • Medicaid
    A government health insurance program that provides financial medical assistance to those who cannot afford to pay for coverage, according to state specified levels.  
  • Medical Decision-Making
    A term by the American Medical Association for clinical decision-making. See also: Clinical Decision Making.  
  • Medical Necessity
    A term Referring to guidelines to determine whether an activity or treatment is justifiable as reasonable for a given condition. May or may not be related to indication.See also: Indication.  
  • Medical Record
    Doctor record, clinical record, or health record of a patient, which includes all documentation of a patient's medical history, and treatment rendered by a provider for providers in a clinic or facility. In the case of a patient, The medical record would consist of all records from all doctors(...)
  • Medicare
    A federal health insurance program for individuals over the age of 65 and also people with disabilities due to certain specific diseases or injuries.  
  • Mobilization
    Movements applied within the normal range of motion of the joint without the inclusion of a thrust or impulse, with the goal of improving joint movement, position, remodeling joint surfaces, or normalizing stabilizing muscle and ligament function in the region.  
  • Modifiers
    A component of the code used to describe the procedures provided for therapy. Often required for proper claims billing. See also: CPT code.  
  • Multiple
    More than one site (location), diagnosis, or problem.
  • Myelopathy
    A term used to describe pathological changes in the spinal cord, typically as a result of a disease or injury or process.  Would typically be characteristic of describing a more serious injury to the spinal cord.
  • Myo
    A prefix meaning muscle, as in "myofascial", or "myofascitis". See also -itis.  
  • ORTHOTICS
    Often loosely described, an orthotic is, in the clinical sense, a prescriptive, specialized, and typically customized insole (or add-on to an insole), that fulfills a postural or biomechanical purpose for a diagnosis of a problem or issue. An orthotic is different from a padded insole, in that(...)
  • Pre-Existing Conditions
    Pre-existing conditions are problems that are typically related to the problem at hand, that may change the way we understand the onset of a problem. For example, if you have previously sprained your low back, then a new sprain of your lumbar spine might be a chronic reoccurrence, as opposed(...)
  • Pre-existing conditions
    Problems that are typically related to the problem at hand, that change the way we understand the onset of a problem. For example, if you have previously sprained your low back, then a new sprain of your lumbar spine might be a chronic recurrence (reoccurrence), as opposed to an acute new(...)
  • Subluxation
    A derangement, fixation, or dysfunction of a joint, with functional, nerve, blood supply or systemic organ effects, often from a trauma or a continued micro-trauma, and can be painful locally or refer pain farther away (distally). A subluxation may typically present with decreased or increased(...)
  • Thoracic Spine
    The Thoracic spine describes the 12 Thoracic Vertebrae of the "mid-back", numbered T1 through T12. The Ribs articulate with the Thoracic spinal vertebrae.