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Modifiers
In language, words, phrases, or clauses that provide additional information about other elements in a sentence without altering the primary meaning. In billing, codes that indicate additional factors impacting healthcare services.
AMA Defines Medical Necessity
Guidelines established by the American Medical Association that determine the necessity and appropriateness of specific healthcare services or procedures.
Prudent Physician
A legal standard referring to the care and judgement that a competent physician, in similar circumstances, would provide.
Generally Accepted Standard
Generally Accepted Standard refers to a principle, norm, or criterion that is widely recognized and accepted in a particular field or industry.
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