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Healthcare: Coding Systems & Reimbursement Glossary
A free, platform-curated glossary of the coding systems, reimbursement mechanics, and health-IT terms that structure the U.S. medical market. Definitions are drawn from public CMS, HHS, and standards-body materials and written in precise plain language. Built for developers, analysts, and new-to-industry staff who need to decode ICD, CPT, DRG, RVU, and payer terminology quickly and without paying for reference material.
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"records": [
{
"term": "International Classification of Diseases, Clinical Modification",
"category": "Coding",
"definition": "Standardized diagnosis codes used to describe conditions on claims and records.",
"abbreviation": "ICD-10-CM"
},
{
"term": "Current Procedural Terminology",
"category": "Coding",
"definition": "AMA-maintained codes for physician and outpatient procedures and services.",
"abbreviation": "CPT"
},
{
"term": "Healthcare Common Procedure Coding System",
"category": "Coding",
"definition": "Codes for supplies, drugs, and services not covered by CPT, used by Medicare.",
"abbreviation": "HCPCS"
},
{
"term": "Medicare Severity Diagnosis-Related Group",
"category": "Payment",
"definition": "Inpatient case classification that sets a bundled Medicare payment amount.",
"abbreviation": "MS-DRG"
},
{
"term": "Relative Value Unit",
"category": "Payment",
"definition": "Unit measuring the resources in a service; multiplied by a conversion factor to set fees.",
"abbreviation": "RVU"
},
{
"term": "Resource-Based Relative Value Scale",
"category": "Payment",
"definition": "Framework Medicare uses to price physician services from work, practice, and liability RVUs.",
"abbreviation": "RBRVS"
},
{
"term": "National Provider Identifier",
"category": "Identifier",
"definition": "Unique 10-digit number identifying a healthcare provider on transactions.",
"abbreviation": "NPI"
},
{
"term": "National Drug Code",
"category": "Identifier",
"definition": "FDA identifier for a specific drug product, package, and manufacturer.",
"abbreviation": "NDC"
},
{
"term": "Fee-for-Service",
"category": "Payment model",
"definition": "Payment model that reimburses each individual service rendered.",
"abbreviation": "FFS"
},
{
"term": "Capitation",
"category": "Payment model",
"definition": "Fixed per-member per-month payment regardless of services used.",
"abbreviation": "—"
},
{
"term": "Prior Authorization",
"category": "Utilization",
"definition": "Payer approval required before a service or drug is covered.",
"abbreviation": "PA"
},
{
"term": "Explanation of Benefits",
"category": "Claims",
"definition": "Statement showing how a claim was processed and what the patient owes.",
"abbreviation": "EOB"
},
{
"term": "Formulary",
"category": "Pharmacy",
"definition": "List of drugs a plan covers, often organized into cost tiers.",
"abbreviation": "—"
},
{
"term": "Logical Observation Identifiers Names and Codes",
"category": "Interoperability",
"definition": "Universal codes for lab tests and clinical observations.",
"abbreviation": "LOINC"
},
{
"term": "Health Insurance Portability and Accountability Act",
"category": "Compliance",
"definition": "Federal law setting privacy and security rules for protected health information.",
"abbreviation": "HIPAA"
}
],
"sources": [
{
"url": "https://www.cms.gov/medicare/coding-billing",
"name": "CMS — Medicare Learning Network & Coding Resources"
},
{
"url": "https://www.cdc.gov/nchs/icd/icd-10-cm.htm",
"name": "CDC — ICD-10-CM Official Resources"
}
],
"category": "glossary",
"vertical": "healthcare",
"data_note": "All records are public-domain facts compiled from the cited sources as of the asOf date. This content is authored and served by the platform itself — it is not seller data, so the marketplace's zero-storage promise about seller datasets is unaffected.",
"record_count": 15,
"what_this_is": "A platform-published open-data listing curated by Open Data Desk, the marketplace's in-house public-data seller. It is real free inventory: it counts in marketplace statistics and is purchasable for $0 through the normal purchase flow, which delivers this payload with an Ed25519-signed receipt.",
"record_schema": {
"term": "Term, code system, or metric",
"category": "Domain the term belongs to",
"definition": "Plain-language meaning",
"abbreviation": "Common abbreviation or short form"
},
"buyer_use_cases": [
"Onboard new billing, product, or data staff with a precise, citable healthcare vocabulary.",
"Normalize field labels and documentation in claims and analytics pipelines."
]
}The full dataset is delivered after purchase. Fingerprint: sha256:e925fa6000d65471042bcf38d33afbc1e6b0337de761f875367b9cab3d164c3a
No answered questions yet — ask the seller anything about this listing.
Data is contributed by independent third-party sellers. Vertical Marketplace facilitates the transaction; sellers keep 95% on everyday sales from $20 to $49,999.99 under the year-one founding rate locked through 2027-06-30 (full schedule: GET /api/meta). Prohibited content (digital keys/licenses/game codes, and health data the seller does not own — e.g. patient records) is not permitted; individuals may sell their own personal health data only via the signed Health Data Consent Flow. See /terms.
- Use the purchased data for your own commercial and non-commercial work
- Create derivative analyses, models, and works from the data
- No reselling or re-listing the purchased data on this or any other marketplace
- No redistributing the raw dataset as-is to third parties
- Exclusive listings are sold to a single buyer and delisted on purchase
- Limited listings are sold to a capped number of buyers and delisted once sold out
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