Acronym/Terminology Index

Published 10/11/2022

Select an alpha character to go to that section on the acronym list.

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Acronym Definition
ABN 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)
BBA Balanced Budget Act
BETOS Berenson Eggers Type of Service
BIPA "Medicare, Medicaid & SCHIP" Benefits Improvement & Protection Act of 2000
BLS Basic Life Support (ambulance)
CAC 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
DAB 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
ED 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
FAQ 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
HCPCS 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
ICD-9-CM 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

Implementation Guide (HIPAA)

IPPS Implementation Guide (HIPAA)
Inpatient Prospective Payment System
IRF Inpatient Rehabilitation Facility
IVR Interactive Voice Response
JJ 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 
LCD Local Coverage Determination (medical policy)
LOC Level of Care
LTC Long Term Care
LTCF Long Term Care Facility
MA-PD 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
NCD 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
OBRA 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
PA 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)
QIC Qualified Independent Contractor
QIO Quality Improvement Organization
QMB Qualified Medicare Beneficiary (Medicare/Medicaid)
QPP Quality Payment Program
RA 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
SAD 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
TC 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
UPIN Unique Provider Identification Number
USP U.S. Pharmacopoeia
WA Working Aged
WBT Web-Based Training
WC Workers' Compensation
WEDI Workgroup for Electronic Data Interchange
WHO World Health Organization
ZIP Zoning Improvement Plan (ZIP Codes)

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