Starting a Medical Practice Key Terms

Know the language when starting a medical practice

By Lori Carver

Starting a medical practice may not be too different than starting any other business, but there is one area that will require extensive knowledge and that is the use of medical terms. Even if you are only working the business end you will come across many medical terms and must know what these terms mean. There are also key codes you will need to learn in order to bill for your medical business. You will need to be aware of the medical laws and the agencies that govern them. Look at the following key terms when starting a medical practice.

Clinical practice guidelines

Clinical practice guidelines are statements set up in medical practices for and by health-care professionals outlining specific courses of action that patients should take should they suffer from an ailment. This helps both the patients and the health-care professionals decide appropriate action and treatment for the patient.
Try: National Heart Lung and Blood Institute provides detailed information about clinical practice guidelines.

ICD9

ICD9, or International Classification of Diseases, is the code in medical practice used by health-care professionals to classify the disease. Instead of typing a word such as diabetes, the code assigns a number (for diabetes it is 249).
Try: ICD9 Chrisendres offers a free searchable data base of ICD9 codes. National Center for Health Statistics provides information on ICD9 codes and other codes used by the medical profession.

HCPCS

HCPCS, or Healthcare Common Procedure Coding System, differs from ICD9 codes in that the ICD9 code refers to the disease the patient has, while the HCPCS code refers to the treatment the patient received from the doctor's medical practice.
Try: U.S. Department of Health and Human Services offers more information regarding HCPCS codes including some government regulations regarding codes and medical practice. ICD9 Data offers a free searchable database of all HCPCS codes from the current year back to 2005.

HIPAA

HIPAA, or Health Insurance Portability and Accountability Act, is a federal act that became law in 1996 to protect the privacy of patient medical records. All medical practice staff personel must adhere to this law.
Try: HIPAA provides details, including the full statement of the law, as well as enforcement and security regarding the law and medical practice.

Observation

Observation in medical practices means watching a patient closely to decide if he or she should be admitted to a hospital, seek treatment at an outpatient facility or go home.
Try: The University of Arizona opened a medical observation unit to observe patients not yet admitted but in need of observation.

Primary care physician, or PCP

A primary care physician, or PCP, is the general practitioner of a medical practice who cares for all family members, including children. Other primary-care physicians include general internists and pediatricians.
Try: Care Counsel provides extensive information about primary-care physicians and their duties.