Acronym/Terminology Index
Published 10/11/2022
Select an alpha character to go to that section on the acronym list.
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Acronym
Definition
Advance Beneficiary Notice
ADJ
Adjusted Claim
ADR
Additional Documentation Request
ALJ
Administrative Law Judge
ALS
Advanced Life Support (ambulance)
ANSI
American National Standards Institute
APMs
Alternative Payment Models
ASC
Ambulatory Surgical/Surgery Center
ASCA
Administrative Simplification Compliance Act
ASP
Average Sale Price
AWP
Average Wholesale Price (drugs)
Balanced Budget Act
BETOS
Berenson Eggers Type of Service
BIPA
"Medicare, Medicaid & SCHIP" Benefits Improvement & Protection Act of 2000
BLS
Basic Life Support (ambulance)
Contractor Advisory Committee
CAH
Critical Access Hospital
CARC
Claim Adjustment Reason Code
CB
Consolidated Billing
CBIC
Competitive Bidding Implementation Contractor
CBR
Comparative Billing Report
CBT
Computer Based Training
CCI
Correct Coding Initiative
CCN
Claim Control Number
CDC
Center for Disease Control
CERT
Comprehensive Error Rate Testing program
CFR
Code of Federal Regulations
CHC
Comprehensive Health Center
CLIA
Clinical Laboratory Improvement Act
CMHC
Community Mental Health Center
CMN
Certificate of Medical Necessity
CMR
Comprehensive Medical Review
CMS
Centers for Medicare & Medicaid Services
CNS
Clinical Nurse Specialist
COA
Change of Address
COB
Close of Business
COB
Coordination of Benefits
COBC
Coordination of Benefits Contractor
COB&R
Coordination of Benefits & Recovery
COBRA
Consolidated Omnibus Budget Reconciliation Act of 1985
CORF
Comprehensive Outpatient Rehabilitation Facility
CPIL
Claims Payment/Processing Issues Log
CPO
Care Plan Oversight
CPT-4
Current Procedural Terminology
CR
Change Request
CRNA
Certified Registered Nurse Anesthetist
CSW
Clinical Social Worker
CWF
Common Working File
CWF/MSP
Common Working File/Medicare Secondary Payer
CY
Calendar Year
Departmental Appeals Board (ALJ)
DCN
Document Control Number
DHHS
Department of Health and Human Services
DMAC
DME Medicare Administrative Contractor
DME
Durable Medical Equipment
DMEPOS
Durable Medical Equipment, Prosthetics, Orthotics and Supplies
DOE
Date of Entitlement
DOD
Date of Death
DOJ
Department of Justice
DOS
Date of Service
DX
Diagnosis
Emergency Department
EDI
Electronic Data Interchange
EFT
Electronic Funds Transfer
EGHP
Employer Group Health Plan
EIN
Employer Identification Number
E/M
Evaluation and Management
EMT
Emergency Medical Technician
EMTALA
Emergency Medical Treatment & Active Labor Act
EOB
Explanation of Benefits
ERA
Electronic Remittance Advice
ERN
Electronic Remittance Notice
ESRD
End Stage Renal Disease
Frequently Asked Question
FDA
Food and Drug Administration
FFS
Fee-for-Service
FI
Fiscal Intermediary
FISS
Fiscal Intermediary Shared (or Standard) System
FOIA
Freedom of Information Act
FQHC
Federally Qualified Health Center
FR
Federal Register
FY/CY
Fiscal Year/Calendar Year
Health Care Procedure Coding System
HHA
Home Health Agency
HHH
Home Health and Hospice
HHS
Department of Health and Human Services
HIC
Health Insurance Claim
HICN
Health Insurance Claim Number (Medicare Number)
HIMR
Health Insurance Master Record (Social Security)
HIPAA
Health Insurance Portability and Accountability Act of 1996
HMO
Health Maintenance Organization
HPSA
Health Professional (or Personnel) Shortage Area
International Classification of Diseases, 9th Revision, Clinical Modification
ICD-10-CM
International Classification of Diseases, 10th Revision, Clinical Modification
ICN
Internal Control Number
IDE
Investigational Device Exemption
IDTFs
Independent Diagnostic Testing Facilities
IG
Implementation Guide (HIPAA)
IPPS
Implementation Guide (HIPAA)
Inpatient Prospective Payment System
Inpatient Prospective Payment System
IRF
Inpatient Rehabilitation Facility
IVR
Interactive Voice Response
Jurisdiction J Part A and Part B providers in Alabama, Georgia and Tennessee
JM
Jurisdiction M Part A and Part B providers in North Carolina, South Carolina, Virginia and West Virginia
JM HHH
Jurisdiction M Home Health and Hospice providers in Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee and Texas
Local Coverage Determination (medical policy)
LOC
Level of Care
LTC
Long Term Care
LTCF
Long Term Care Facility
Medicare Advantage Prescription Drug Plans
MACRA
Medicare Access and CHIP Reauthorization Act of 2015
MA Plan
Medicare Advantage Plan (formerly Medicare+Choice or Medicare HMO)
MAC
Medicare Administrative Contractor
MBI
Medicare Beneficiary Identifier
MCD
Medicare Coverage Database
MCO
Managed Care Organizations
MCS
Multicarrier System
MEDIGAP
A Medicare complementary insurance program
MEDPARD
Medicare Participating Physician and Supplier Director
MEI
Medicare Economic Index
MFS
Medicare Fee Schedule
MIPS
Merit-based Incentive Payment System
MN
Medical Necessity
MPFSDB
Medicare Physician Fee Schedule Data Base
MR
Medical Review
MSN
Medicare Summary Notice (notice to beneficiaries)
MSP
Medicare Secondary Payer
MUA
Medically Underserved Area
MUE
Medically Unlikely Edit
National Coverage Determination
NDC
National Drug Code
NOC
Not Otherwise Classified
NP
Nurse Practitioner
NPI
National Provider Identifier
NPP
Non-physician Practitioner
NPPES
National Plan and Provider Enumeration System
NSC
National Supplier Clearinghouse
NTIOLs
New Technology Intraocular Lenses
NIBC
National Uniform Billing Committee
NUCC
National Uniform Claim Committee
Omnibus Budget Reconciliation Act
OCE
Outpatient Code Editor (system)
OIG
Office of Inspector General
OPPS
Outpatient Prospective Payment System
OTAF
Obligated to Accept as Payment in Full
OTC
Over the Counter Drug
Physician Assistant
PA
Prior Authorization
PC
Professional Component
PCC
Provider Contact Center
PCP
Primary Care Physician (or Provider)
PCR
Pre-Claim Review
PDP
Prescription Drug Plan
PDR
Physician's Desk Reference
PECOS
Provider Enrollment, Chain and Ownership System
PFS
Physician Fee Schedule
PHI
Protected Health Information (see also: HIPAA)
PIN
Provider Identification Number (see also: PTAN)
POC
Plan of Care
POS
Place of Service
PPO
Preferred Provider Organization
PPS
Prospective Payment System
PQRI
Physician Quality Reporting Initiative
PR
Patient Responsibility
PSC
Program Safeguard Contractor
PTAN
Provider Transaction Access Number (formerly PIN)
Qualified Independent Contractor
QIO
Quality Improvement Organization
QMB
Qualified Medicare Beneficiary (Medicare/Medicaid)
QPP
Quality Payment Program
Remittance Advice
RAC
Recovery Audit Contractor
RARC
Remittance Advice Remark Code
RBRVS
Resource Based Relative Value Scale
RHC
Rural Health Clinic
RHHI
Regional Home Health Intermediary
RO
Regional Office (CMS)
RRB
Railroad Retirement Board
RRB SMAC
Railroad Retirement Board Specialty Medicare Administrative Contractor
RT
Respiratory Therapy
RVS
Relative Value Scale (or schedule)
RVU
Relative Value Unit
Self Administered Drug
SCHIP
State Children's Health Insurance Program
SHIPs
State Health Insurance Assistance Programs
SMAC
Specialty Medicare Administrative Contractor
SNC
Skilled Nursing Care
SNF
Skilled Nursing Facilities
SSA
Social Security Administration
SSI
Supplemental Security Income
SSN
Social Security Number
Technical Component
TEFRA
Tax Equity and Fiscal Responsibility Act of 1982 (PL97248)
TENS
Transcutaneous Electrical Nerve Stimulation
TIN
Tax Identification Number
TOS
Type of Service
TPE
Targeted Probe and Educate
TTY
Text Telephones
Unique Provider Identification Number
USP
U.S. Pharmacopoeia
Working Aged
WBT
Web-Based Training
WC
Workers' Compensation
WEDI
Workgroup for Electronic Data Interchange
WHO
World Health Organization
Zoning Improvement Plan (ZIP Codes)