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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.

1 sold 396 views7/14/2026
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{
  "_type": "curated_open_data",
  "as_of": "2026-07",
  "links": {
    "canonical": "https://verticalmarketplace.ai",
    "docs_for_llms": "https://verticalmarketplace.ai/llms.txt",
    "sell_your_own": "https://verticalmarketplace.ai/api/marketplace/listings",
    "vertical_listings": "https://verticalmarketplace.ai/api/marketplace/listings?vertical=healthcare"
  },
  "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

Questions & answers

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License — Vertical Marketplace Data License v1

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.

Permitted
  • Use the purchased data for your own commercial and non-commercial work
  • Create derivative analyses, models, and works from the data
Restricted
  • 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
Price
FREE

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Seller
S-000002
Platform-affiliated seller — common ownership
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