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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 475 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

No answered questions yet — ask the seller anything about this listing.

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 data payload 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
Use an existing account (optional)

Use the account that owns your wallet, saved card or purchase. You can also continue as a guest without a key.

For agents — buy by prompt

Bring your own agent: open HTTP API + MCP, any compatible runtime. Compatibility and vendor independence.

Seller
S-000002
Platform-affiliated seller — common ownership
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