Acronyms, initialisms, and alphabetisms are abbreviations that are formed using the initial components in a phrase or name. These components may be individual letters (as in CMS) or parts of words. The following acronyms are used frequently on the National Government Services, Centers for Medicare & Medicaid Services, Medicare, and health care industry Web sites.
Acronym | Term |
---|---|
AARP | American Association of Retired Persons |
ABG | arterial blood gas |
ABN | Advance Beneficiary Notice of Noncoverage |
ACH | acute care hospital |
ADMC | advanced determination of Medicare coverage |
ADP | automated data processing |
ADR | additional development request |
AFO | ankle-foot orthotic |
AIC | amount in controversy |
ALJ | Administrative Law Judge |
ALOS | average length of stay |
ALS | amyotrophic lateral sclerosis |
AMA | American Medical Association |
ANSI | American National Standards Institute |
AOB | assignment of benefits |
APC | ambulatory payment classification |
ARD | assessment reference date |
ASC | Accredited Standards Committee |
ASCA | Administrative Simplification Compliance Act |
ASP | average sales price |
ATP | assistive technology practitioner |
ATS | assistive technology supplier |
AWP | average wholesale price |
BBA | Balanced Budget Act of 1997 |
BBRA | Balanced Budget Refinement Act of 1999 |
BE | benefits exhausted |
BIPA | Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000 |
BIB | break in billing |
BIS | break in service (break-in-service claim) |
BIU | Benefit Integrity Unit |
CAC | Carrier Advisory Committee |
CAD | computer-aided design |
CAH | critical access hospital |
CAM | computer-aided manufacturing |
CAPD | continuous ambulatory peritoneal dialysis |
CAT | computerized axial tomography |
CB | Consolidated billing |
CBA | competitive bidding area |
CBIC | Competitive Bidding Implementation Contractor |
CBSA | Core-based statistical area |
CBT | computer-based training |
CC | Condition code |
CCPD | Continuous cycling peritoneal dialysis |
CCN | claim control number |
CCR | cost-to-charge ratio |
CDC | CERT Documentation Contractor |
CDE | Certified diabetic educators |
CEDI | Common Electronic Data Interchange |
CELIP | Claim expansion and line item processing |
CERT | Comprehensive Error Rate Testing |
CEU | Continuing education units |
CF | Conversion factor |
CFO | Chief financial officer |
CFR | Code of Federal Regulations |
CHOW | Change of ownership |
CLIA | Clinical Laboratory Improvement Amendments |
CMD | Contractor medical director |
CMG | Case-mix group |
CMHC | Community mental health center |
CMN | Certificate of Medical Necessity |
CMR | Comprehensive medical review |
CMS | Centers for Medicare & Medicaid Services |
CMS-1450 | Uniform Bill (UB-04) (for Part A) |
CMS-1500 | Health Insurance Claim Form (for Part B and DME) |
CMS-Â1696 | Appointment of Representative form |
CMS-20034 | Request for Medicare Hearing by an Administrative Law Judge form |
CMS-382 | ESRD Beneficiary Selection form |
CMS-5011B | Request for Part B Medicare Hearing by an Administrative Law Judge form |
CMS-588 | Electronic Funds Transfer (EFT) Authorization Agreement form |
CMS-855S | Medicare Enrollment Application form |
CMS-R-131 | Advance Beneficiary Notice of Noncoverage (ABN) form |
CNM | Certified nurse midwife |
CNS | Certified nurse specialist |
CO | Central office (CMS, in Baltimore, MD) |
CO | Contracting officer |
CO | contractual obligation |
COBC | Coordination of Benefits Contractor |
COBRA | Consolidation Omnibus Budget Reconciliation Act of 1986 |
COP | Conditions of participation |
CORF | Comprehensive outpatient rehabilitation facility |
CP | Clinical psychologist |
CPI | Consumer price index |
CPO | Care plan oversight |
CPT/CPT-4 | Current procedural terminology |
CPT | Claims processing timeliness |
CR | Change Request |
CRC | CERT Review Contractor |
CRNA | Certified registered nurse anesthetist |
CSI | Claim Status Inquiry |
CSW | Clinical social workers |
CWF | Common Working File (also known as HIMR) |
DAB | departmental appeals board |
DCN | document control number |
DDE | Direct Data Entry |
DGME | direct graduate medical education |
DHHS | Department of Health and Human Services (also referred to as HHS) |
DIF | DME Information Form |
DME | durable medical equipment |
DMECS | Durable Medical Equipment Coding System |
DME MAC | Durable Medical Equipment Medicare Administrative Contractor |
DMEPOS | durable medical equipment prosthetics, orthotics and supplies |
DMERC | durable medical equipment regional carrier |
DO | Doctor of osteopathy |
DOA | date of accident |
DOB | date of birth |
DOD | date of death |
DOJ | Department of Justice |
DOL | Department of Labor |
DOS | date of service |
DPM | Doctor of podiatric medicine |
DPU | distinct-part unit |
DRA | Deficit Reduction Act of 2005 |
DRG | diagnosis-related group |
DSMT | diabetes self-management training |
EDI | Electronic data interchange |
EFT | Electronic funds transfer |
EGHP | Employer group health plan |
EIN | Employer Identification Number |
E&M | Evaluation and management |
EMC | Electronic media claim |
EMR | Electronic medical record |
EOB | Explanation of benefits |
EPO | Epoetin |
ER | Emergency room |
ERA | Electronic remittance advice |
ESA | Erythropoiesis stimulating agent |
ESRD | End-stage renal disease |
FAQ | Frequently asked question |
FBI | Federal Bureau of Investigation |
FCN | Financial control number |
FI | Fiscal intermediary |
FISS | Fiscal Intermediary Standard System (processing system for Part A) |
FL | Field Locator |
FOI | Freedom of Information |
FOIA | Freedom of Information Act |
FQHC | Federally qualified health center |
GAO | General Accounting Office; or Government Accountability Office |
GHP | Group health plan |
GME | Graduate medical education |
GPCI | Geographic practice cost index |
HCO | High cost outlier |
HCPCS | Healthcare Common Procedure Coding System |
HHA | Home health agency |
HIC | Health Insurance Claim (Number) |
HICN | Health Insurance Claim Number |
HIMR | Health Insurance Master Record (also known as CWF) |
HIPAA | Health Insurance Portability and Accountability Act |
HIPPS | Health insurance prospective payment system (code) |
HIQA | Health Insurance Query Access (CWF) |
HME | Home medical equipment |
HMO | Health maintenance organization |
HPSA | Health professional shortage area |
HRSA | Health Resources Services Administration |
HSQB | Health Standards Quality Bureau |
IACS-PC | Individuals Authorized Access to CMS Computer Services—Provider Community |
ICD-9-CM | International Classification of Diseases, Clinical Modification, 9th Revision |
ICD-10-CM | International Classification of Diseases, Clinical Modification, 10th Revision |
ICN | Internal control number |
IDTF | Independent diagnostic testing facility |
IIC | Inflation-indexed charge |
IG | Inspector General |
IME | Indirect medical education |
IOM | (CMS) Internet-Only Manual |
IPPE | Initial physical preventive examination |
IPF | Inpatient psychiatric facility |
IPPS | Inpatient prospective payment system |
IRF | Inpatient rehabilitation facility |
IRP | Inexpensive or other routinely purchased DME |
IRVEN | Inpatient rehabilitation validation and entry |
IV | Intravenous |
IVR | Interactive voice response (system) |
IRS | Internal Revenue Service |
JSM | Joint Signature Memorandum |
KAFO | Knee-ankle foot orthotic |
LCD | Local coverage determination |
LCL | Lowest charge level |
LGHP | Large group health plan |
LIDOS | Line item date of service |
LIP | Low income payment |
LOS | Length of stay |
LPM | Liters per minute |
LSO | Lumbar-sacral orthosis |
LTC DRG | Long-term care diagnosis-related group |
LTCH | Long-term care hospital |
LTR | Lifetime reserve (days) |
MAC | Medicare Administrative Contractor, Medicare appeals council |
MAE | mobility assistive equipment |
MAO | Medicare Advantage organization |
MCE | Medicare code editor |
MCFU | Medicaid Fraud Control Units |
MCS | Multi-Carrier System (processing system for Medicare Part B) |
MD | Doctor of medicine |
MDS | minimum data set |
MEDPARD | Medicare Participating Physician/Supplier Directory |
MHO | Medicare hearing officer |
MIP | Medicare Integrity Program |
MMA | Medicare Modernization Act of 2003 |
MPDIMA | Medicare Prescription Drug, Improvement, and Modernization Act of 2003 |
MPFS | Medicare physician fee schedule |
MPFSDB | Medicare physician fee schedule database |
MREP | Medicare Remit Easy Print (software) |
MRI | magnetic resonance imaging |
MRN | Medicare redetermination notice |
MSA | Metropolitan statistical area |
MSN | Medicare Summary Notice |
MSP | Medicare Secondary Payer |
N&AH | nursing and allied health |
NCD | national coverage determination |
NCCI | National Correct Coding Initiative |
NCPDP | National Council for Prescription Drug Programs |
NDC | national drug code |
NF | nursing facility |
NOC | not otherwise classified (code) |
NON PAR | nonparticipating provider |
NP | nurse practitioner |
NPI | National Provider Identifier |
NPP | nonphysician practitioner |
NPPES | National Plan and Provider Enumeration System |
NPWT | negative pressure wound therapy |
NSC | National Supplier Clearinghouse |
NSF | national standard format |
OAS | Office of Audit Service (of the Department of Health and Human Services) |
OBRA | Omnibus Budget Reconciliation Act |
OC | Occurrence code |
OCE | Outpatient code editor |
OCIG | Office of Counsel to the Inspector General |
OD | Optometrist (doctor of optometry) |
OI | Office of Investigations |
OIFO | Office of Investigations Field Office (OIG) |
OIG | Office of Inspector General |
OMB | Office of Management and Budget |
OPPS | Outpatient prospective payment system |
ORF | Outpatient rehabilitation facility |
ORU | Overpayment Recovery Unit |
OSC | Occurrence span code |
OSCAR | Online Survey, Certification and Reporting (OSCAR System) |
OT | Occupational therapist/occupational therapy |
OTR | On-the-record hearing |
PA | policy article |
PAI | patient assessment instrument |
PA | physician assistant |
PAR | participating provider |
PCA | progressive corrective action |
PDAC | Pricing, Data Analysis and Coding (Contractor) |
PECOS | Provider Enrollment, Chain and Ownership System |
PEN | parenteral and enteral nutrition |
PHI | protected health information |
PIN | Provider Identification Number |
PIP | Periodic interim payment |
P&O | prosthetic and orthotic |
PMD | power mobility device |
POE | Provider outreach and education |
POS | place of service |
POTR | Preliminary on-the-record hearing |
POV | Power-operated vehicle |
PPO | Preferred provider organization |
PPS | prospective payment system |
PPTN | Professional Provider Telecommunications Network |
PPV | Pneumococcal pneumonia vaccine |
PSC | program safeguard contractor |
PT | physical therapist |
PTAN | Provider Transaction Access Number |
PWC | power wheelchair |
QIC | Qualified independent contractor |
QIO | Quality improvement organization |
RA | Recovery Auditor |
RBRVU | Resource-based relative value unit |
RDF | Renal dialysis facility |
RESNA | Rehabilitation Engineering and Assistive Technology of North America |
RFA | Regulatory Flexibility Act |
RHC | Rural health clinic |
RHHI | Regional home health intermediary |
RIC | Rehabilitation impairment category |
RICO | Racketeering Influenced Corrupt Organization |
RO | Regional office (CMS) |
RRC | Rural Referral Center |
RTP | return to provider |
RUG | Resource utilization group |
RVU | Relative value unit |
SADMERC | Statistical Analysis DMERC (now referred to as the PDAC) |
SCH | Sole community hospital |
SHIP | State Health Insurance Program |
SLP | Speech-language pathology |
SNF | Skilled nursing facility |
SPR | Standard paper remittance |
SSA | Social Security Administration |
SSN | Social Security Number |
TEFRA | Tax Equity and Fiscal Responsibility Act of 1982 |
TENS | Transcutaneous electrical nerve stimulator |
TLSO | Thoracic-lumbar-sacral orthosis |
TOB | Type of bill |
TRU | Telephone reopening unit |
UB | Uniform bill |
UPIN | Unique Physician Identification Number |
VA | Veterans Administration |
VA | Veterans Affairs |
VC | value code |
VTC | Video teleconference |
WAC | wholesale acquisition cost |
WC | workers’ compensation |
YTD | year to date |
MSPRC | Medicare Secondary Payer Recovery Contractor |
PHS | Public Health Services |
BMM | Bone Mass Measurements |
DPA | dual photon absorptiometry |
FDA | Food & Drug Administration |
HBV | Hepatitis B Virus |
HIV | human immunodeficiency virus |
MQSA | Mammography Quality Standards Act |
CHC | Continuous home care |
COLA | Cost of living adjustment |
ECT | Electroconvulsive therapy |
FMR | Focused medical review |
GIP | General inpatient care |
HIQH | Health insurance query for home health agencies |
HHPPS | Home health prospective payment system |
HHRG | Home health resource group |
IDG | Interdisciplinary group |
LPN | Licensed practical nurse |
LUPA | Low utilization payment adjustment |
NHPCS | National Hospice and Palliative Care Organization |
NOE | notice of election |
NOS | not otherwise specified |
OASIS | Outcome and Assessment Information Set |
PACE | Program of All-Inclusive Care for the Elderly |
PEP | Partial episode payment |
POC | Plan of care |
PSC | patient status code |
RAC | recovery audit contractor |
RAP | Request for anticipated payment |
RC | Revenue code/reason code |
RHC | Routine home care |
RN | Registered nurse |
RNHCI | Religious nonmedical health care institution |
SCHIP | State Children’s Health Insurance Program |
S/LOC | Status/location |
PRRS | Provider relations research specialist |
CMI | Case-mix index |
DSH | disproportionate share hospital |
MDH | Medicare dependent hospital |
PRM | Provider Reimbursement Manual (Medicare Publication 15-1/15-2) |
PS&R | Provider Statistical & Reimbursement Report |
SSI | Supplemental security income |
ELGA | Eligibility Inquiry Part A |
FY | Fiscal Year |
ID | Identification |
I/OCE | Integrated Outpatient Code Editor |
MEDA | Medicare Part A |
MUE | Medically Unlikely Edit |
PCC | Provider Contact Center |
TIN | Tax Identification Number |
IP | Inpatient |
OP | Outpatient |
ZPIC | zone program integrity contractor |
TMR | Targeted medical review |
PER | Payment error rates |
CER | Claim error rates |
SER | Service error rates |
KPS | Karnofsky performance status |
PRN | Pro re nata |
SOB | Shortness of breath |
NCH | National Claims History (System) |
MCPSS | Medicare contractor provider satisfaction survey |
MRA | Medicare remittance advice |
PFS | Physician fee schedule |
DNF | do not forward |
VMS | ViPS Medicare System |
PQRI | Physician Quality Reporting Initiative |
ICF | Intermediate care facility |
MNT | Medical nutrition therapy |
LSO | Local security officer |
COPD | Chronic obstructive pulmonary disease |
CARC | claim adjustment reason code |
PO | Point of origin |
CLFS | Clinical laboratory fee schedule |
WOPD | written order prior to delivery |
PQRS | Physician Quality Reporting System |
RAD | respiratory assist devices |
MPPR | Multiple procedure payment reduction |
NUBC | National Uniform Billing Committee |
MSA | medical service area |
EDC | Enterprise data center |
PCIP | Primary Care Incentive Program |
COB | Coordination of benefits |
HH+H | Home health plus hospice |
HHH | Home health and hospice |
POE AG | Provider Outreach and Education Advisory Group |
NMO | National Mail Order (Program) |
SPA | Single payment amount |
LCMP | Licensed clinical medical professional |
RARC | remittance advice remark codes |
NTE | Note |
RUL | Reasonable useful lifetime |
MLN | Medicare Learning Network |
APS | automated provider screening |
ACA | Affordable Care Act |
LCSW | Licensed clinical social worker |
OCR | Optical character recognition |
NFPP | National Fraud Prevention Program |
NUCC | National Uniform Claim Committee |
EHR | Electronic health record |
MM | MLN Matters |
HETS | HIPAA Eligibility Transaction System |
CMS-460 | Medicare Participating Physician or Supplier Agreement |
CMS-855A | Medicare Enrollment Application - Institutional Providers |
CMS-855B | Medicare Enrollment Application - Clinics/Group Practices and Certain Other Suppliers |
CMS-855I | Medicare Enrollment Application - Physicians and Nonphysician Practitioners |
CMS-855O | Medicare Enrollment Application - Registration for Eligible Ordering and Referring Physicians and Nonphysician Practitioners |
CMS-855R | Medicare Enrollment Application - Reassignment of Medicare Benefits |
LICSW | Licensed independent clinical social worker |
MCTRJCA | Middle Class Tax Relief and Job Creation Act |
PPACA | Patient Protection and Affordable Care Act |
SMRC | Supplemental Medical Review Contractor |
PR | patient responsibility |
EP | Eligible professional |
QCDR | Qualified clinical data registry |
HHS | United States Department of Health and Human Services |
FECA | Federal Employee Compensation Act |
FTE | full-time employee |
GPO | U.S. Government Printing Office |
SIA | supplemental instruction article |
QR | Quick response (CMS-1500 code symbol) |
AAPC | American Academy of Professional Coders |
EEG | electroencephalogram |
BIN | break in need |
ADR | additional documentation request |
BCRC | Benefits Coordination & Recovery Center |
CRC | Commercial Repayment Center |
UOS | unit of service |
PII | personally identifiable information |
HPID | Health plan identifier |
IPP | Indirect payment procedure |
IPP | Indirect payment procedure |
OEID | Other entity identifier |
HQRP | Hospice Quality Reporting Program |
CQM | clinical quality measures |
ADI | advance diagnostic imaging |
SGR | sustainable growth rate |
MCD | Medicare Coverage Database |
BLS | basic life support |
PCS | Physician Certification Statement |
CPAP | continuous positive airway pressure |
PAP | positive airway pressure |
FFS | fee for service |
IBT | intensive behavioral therapy |
ADS | Automated Development System (Part B letter) |
STI | sexually transmitted infections |
CCI | Correct Coding Initiative |
ALS | advanced life support |
ASC | ambulatory surgical center |
ET | eastern time |
PT | physical therapy |
PT | pacific time |
PPS | palliative performance score |
CT | central time |
J6 | Jurisdiction 6 A/B Medicare Administrative Contractor |
JK | Jurisdiction K A/B Medicare Administrative Contractor |
JB | Jurisdiction B Durable Medical Equipment Medicare Administrative Contractor |
CCN | CMS Certification Number |
CCR | Customer Care Representative |
DOA | date of accretion |
CY | calendar year |
FL | Form Locator |
FTE | full-time equivalent |
RA | remittance advice |
HIH | health information handler |
esMD | electronic submission of medical documentation |
SMRC | Specialty Medical Review Contractor |
MR | Medical Review |
HIGLAS | Healthcare Integrated General Ledger Accounting System |
CID | claim identification number |
GAF | Geographic Adjustment Factor |
DEA | Drug Enforcement Administration |
SAMHSA | Substance Abuse and Mental Health Services Administration |
OTP | Opioid Treatment Program |
OSA | Obstructive Sleep Apnea |
ACIP | Advisory Committee on Immunization Practices |
ACP | advance care planning |
AUC | appropriate use criteria |
CDR | clinical dementia rating |
CDSM | clinical decision support mechanism |
CMS SOG | CMS Survey and Operations Group |
COA | Certificate of Accreditation |
COC | Certificate of Compliance |
COR | Certificate of Registration |
COW | Certificate of Waiver |
FAST | functional assessment staging test |
HRA | health risk assessment |
IDE | Investigational Device Exemption |
LVAM | Large Various Adjustment Macro |
MAT | medication-assisted treatment |
OPD | outpatient department |
OUD | opioid use disorder |
PAR | prior authorization request |
PHE | public health emergency |
PPMP | Provider Performed Microscopy Procedures |
PWK | paperwork segment |
SAD | self-administered drug |
SEP | Separate enrollment period |
STC | status information segment |
USPSTF | United States Preventive Services Task Force |
UTN | unique tracking number |
A/P | Assessment/Plan |
AA | Armed Forces Americas |
AAA | abdominal aortic aneurysm |
AAP | accelerated or advanced payment |
AAPC | American Academy of Professional Coders |
ACIP | Advisory Committee on Immunization Practices |
ACOs | accountable care organizations |
ACP | Advance Care Planning |
ACT | Ask the Contractor |
ADL | activities of daily living |
AE | Armed Forces Africa |
AE | Armed Forces Canada |
AE | Armed Forces Europe |
AE | Armed Forces Middle East |
AED | automated external defibrillator |
A-Fib | atrial fibrillation |
AK | Alaska |
AKI | acute kidney injury |
AL | Alabama |
AO | Authorized Official |
AP | Armed Forces Pacific |
API | application program interface |
APM | Alternative Payment Model |
APP | advanced practice provider |
APRN | advanced practice registered nurse |
AR | Arkansas |
AR | accounts receivable |
ASN | Associate of Science in Nursing |
AUC | Appropriate Use Criteria |
AZ | Arizona |
BBA | Bipartisan Budget Act of 2018 |
BHI | Behavioral Health Integration |
BIE | billed in error |
BMI | body mass index |
BPCI | bundled payments for care improvement |
BSN | bachelor’s degree in nursing |
BSN | Bachelor of Science in Nursing |
BSO | Back-Up Security Officer |
CA | California |
CABG | coronary artery bypass graft |
CAC | certified ambulance coder |
CACO | certified ambulance coder certification |
CAHPS | Consumer Assessment of Healthcare Providers and Sy |
CAHSAH | California Association for Health Services at Home |
CAP | corrective action plans |
CAR | chimeric antigen receptor |
CASPER | Certification and Survey Provider Enhanced Reporti |
CBC | complete blood count |
CBRs | comparative billing reports |
CBRs | credit balance reports |
CCM | chronic care management |
CCM CP | chronic care management care planning |
CD | compact disc |
CDSM | Clinical Decision Support Mechanism |
CEC | Comprehensive End-Stage Renal Disease Care Model |
CED | coverage with evidence development |
CEHRT | Certified Electronic Health Record Technology |
CEM | claim edit module |
CEO | chief executive officer |
CGS | Celerian Group Services |
CHC | certified in healthcare compliance |
CHIP | Children's Health Insurance Program |
CJR | comprehensive care for joint replacement |
CMMI | Capability Maturity Model Integration |
CMMI | Center for Medicare & Medicaid Innovation |
CMO | chief marketing officer |
CMS IOM | Centers for Medicare & Medicaid Services Internet- |
CMS SOG | Centers for Medicare & Medicaid Services Survey an |
CMS-20027 | Medicare Redetermination Request Form - 1st Level |
CMS-20033 | Medicare Reconsideration Request Form - 2nd Level |
CMT | Chiropractic manipulative treatment |
CMT | Case Management Team |
CNP | certified nurse practitioner |
CNS | clinical nurse specialist |
CO | Colorado |
COB | close of business |
CoCM | collaborative care model |
CPB | certified professional biller |
CPC | certified professional coder |
CPHM | certified professional in healthcare management |
CPMA | certified professional medical auditor |
CPPM | certified physician practice manager |
CSCC | Claim Status Category Code |
CSCs | Claim Status Codes |
CSRs | customer service representatives |
CT | computed tomography scan |
CT | Connecticut |
CTA | computed tomography angiography |
CTP | computed tomography perfusion |
CVD | cardiovascular disease |
CXR | chest x-ray |
DAC | Division of Acute Care |
DC | District of Columbia |
DE | Delaware |
DG | Documentation Guidelines |
DIAL | Disability Information and Access Line |
DM | doctor of medicine |
DO | Delegated Official |
DPN | diabetic peripheral neuropathy |
DPNA | denial of payment for new admissions |
DRE | digital rectal examination |
DVD | digital versatile disc |
E&M | evaluation and management |
EBRT | external beam radiation therapy |
ECG | electrocardiogram |
ECR | Electronic Cost Report |
ED | Emergency Department |
EIA | enzyme immunoassay |
EIC | Entity Identifier Code |
EIDM | Enterprise Identity Management |
EIT | Enterprise Information Technology |
EKG | electrocardiogram |
ELISA | enzyme-linked immunosorbent assay |
eMDR | electronic medical documentation request |
eMDR | electronic medical documentation requests |
EMG | electromyography |
EMS | emergency medical service |
eMSN | electronic Medicare Summary Notice |
EMT | emergency medical technician |
ENT | ears, nose, and throat |
EOL | end of life |
ERAs | electronic remittance advices |
ERS | Extended Repayment Schedule |
EUA | emergency use authorization |
EUS | External User Services |
F2F | face to face |
FAQs | frequently asked questions |
FBLP | Federal Black Lung Program |
FCBC | fingerprint-based criminal background checks |
FIPS | Federal Information Processing Standards |
FISS DDE | Fiscal Intermediary Standard System Direct Data En |
FL | Florida |
FTD | face to face |
FYE | Fiscal Year End |
GA | Georgia |
GAD-7 | General Anxiety Disorder-7 |
GEP | general enrollment period |
GERD | gastroesophageal reflux disease |
GI | gastrointestinal |
GU | Guam |
HAART | highly active antiretroviral therapy |
HAC | hospital acquired conditions |
HBO | hyperbaric oxygen |
HCFA | Health Care Financing Administration |
HCRIS | Healthcare Cost Report Information System |
HD | hemodialysis |
HH | home health |
HHCCN | Home Health Change of Care Notice |
HI | Hawaii |
HIFU | salvage high-intensity focused ultrasound |
HIMSS | Healthcare Information Management Systems Society |
HINN | Hospital-Issued Notice of Non-Coverage |
HIS | Hospice Item Set |
HITECH | Health Information Technology for Economic and Cli |
HOPD | hospital outpatient department |
HOPE | Hospice Outcomes and Patient Evaluation |
HPI | history of present illness |
HPV | human papillomavirus |
HQIC | Hospital Quality Improvement Contractor |
HQRS | Healthcare Quality Information System |
HR | heart rate |
I&A | Identity and Access |
IA | Iowa |
ICD-10 | International Classification of Diseases, Clinical |
ICD-9 | International Classification of Diseases, Clinical |
ID | Idaho |
IDE | investigational device exemption |
IEP | initial enrollment period |
IL | Illinois |
IM | intramuscular |
IMRT | intensity-modulated radiation therapy |
IN | Indiana |
Inc. | incorporated |
INR | international normalized ratio |
iQIES | Internet Quality Improvement and Evaluation System |
IRF-PAI | Inpatient Rehabilitation Facility-Patient Assessme |
IVIG | intravenous immunoglobulin |
KS | Kansas |
KY | Kentucky |
LA | Louisiana |
LBN | legal business name |
LDS | facial lipodystrophy syndrome |
LGBTQ | lesbian, gay, bisexual, transgender, questioning |
LLC | limited liability company |
LLL | left lower lobe |
LLP | lower limb prosthetic |
LOB | line of business |
LOINC | logical observation identifiers names and codes |
LTSS | long-term services and supports |
LUTS/BPH | lower urinary tract symptoms/benign prostatic hype |
LVAM | large various adjustment macro |
MA | Medicare Advantage |
MA | Massachusetts |
MACRA | Medicare Access and CHIP Reauthorization Act |
MAR | Medication Administration Record |
MBD | Medicare Beneficiary Database |
MCO | managed care organization |
MCR | Medicare Cost Report |
MCReF | Medicare Cost Report E-Filing |
MD | Maryland |
MDM | medical decision making |
ME | Maine |
MEARIS | Medicare Electronic Application Request Informatio |
MEI | Medicare Economic index |
MH | Marshall Islands |
MI | Michigan |
MIPS | Merit-based Incentive Payment System |
MM/DD/YY | month day year |
MMDDYYYY | month day year |
MMR | Medicare Monthly Review |
MN | Minnesota |
MO | Missouri |
MOA | Medicare outpatient adjudication |
MOA | Memorandum of Agreement |
MOON | Medicare Outpatient Observation Notice |
MP | Northern Mariana Island |
MRA | magnetic resonance angiogram |
MRADL | mobility-related activities of daily living |
MS | Mississippi |
MSG | Multiple Surgery Guidelines |
MSG | message on remits |
MSI | Medicare Administrative Contractor Satisfaction In |
MSN | Master of Science in Nursing |
MST | mountain standard time |
MT | mountain time |
MT | Montana |
NAHC | National Association for Home Care & Hospice |
NASS | North American Spine Society |
NC | North Carolina |
NCCPA | National Commission on Certification of Physicians |
ND | North Dakota |
NE | Nebraska |
NGACO | Next Generation Accountable Care Organization |
NGD | Next Generation Desktop |
NGS | National Government Services |
ngs/ml | nanograms per milliliter |
NGS-ACE | National Government Services Advance Communication |
NGSFS | National Government Services Financial Solutions |
NH | New Hampshire |
NHDD | National Healthcare Decisions Day |
NHPCO | National Hospice and Palliative Care Organization |
NIAM | National Immunization Awareness Month |
NJ | New Jersey |
NM | New Mexico |
NOMNC | Notice of Medicare Noncoverage |
NOS | number of service |
NOTR | Notice of Termination/Revocation |
NSV | network service vendor |
NV | Nevada |
NY | New York |
OB | obstetrician |
OEP | open enrollment period |
OH | Ohio |
OK | Oklahoma |
OMHA | Office of Medicare Hearings and Appeals |
OPD | outpatient department |
OR | Oregon |
OTA | occupational therapy assistant |
OTC | over the counter |
OTPP | occupational therapy private practice |
OUD | opioid use disorder |
PA | prior authorization |
PA | Pennsylvania |
PA | professional association |
PAMA | Protecting Access to Medicare Act |
PAR | prior authorization request |
PARHM | Pennsylvania Rural Health Model |
PBDs | provider-based departments |
PC | professional corporation |
PCE | Primary Care Exception |
PCP | primary care physician |
PCTI | physician certification of terminal illness |
PDGM | Patient-Driven Groupings Model |
PE | practice expense |
PE | Provider Enrollment |
PEPPERs | Program for Evaluating Payment Patterns Electronic |
PET | positron emission tomography |
PEX | Provider Experience |
PFSH | past, family, and social history |
PHE | Public Health Emergency |
PHN | postherpetic neuralgia |
PHP | Partial Hospitalization Program |
PHQ-2 | Patient Health Questionnaire-2 |
PHQ-9 | Patient Health Questionnaire-9 |
PIDD | primary immune deficiency disease |
PLLC | professional limited liability company |
PMH | past medical history |
POA | present on admission |
POA | power of attorney |
PPPS | personalized prevention plan service |
PPT | PowerPoint |
PR | Puerto Rico |
PRRB | Provider Reimbursement Review Board |
PRSS | pressure reducing support surfaces |
PSA | prostate specific antigen |
PST | pacific standard time |
PT/INR | prothrombin time international normalized ratio |
PTA | physical therapist assistant |
PTPP | physical therapy private practice |
PUF | Public Use File |
PWK | paperwork |
QCDRs | Qualified clinical data registries |
QHCP | qualified health care professional |
QIES | Quality Information and Evaluation System |
QIN-QIO | Quality Innovation Network-Quality Improvement Org |
QMs | quality measures |
QPP | Quality Payment Program |
QRDA | Quality Reporting Document Architecture |
QRP | Quality Reporting Program |
QRPs | quality reporting programs |
R&D | research and development |
RA | radiologist assistant" |
RC | revenue code |
RC | reason code |
RF | radio frequency |
RFI | request for information |
RI | Rhode Island |
ROS | review of systems |
SA | state agency |
SBIRT | Screening, Brief Intervention, & Referral to Trea |
SBRT | Stereotactic Body Radiation Therapy |
SC | subcutaneous |
SC | South Carolina |
SCF | Settlement Conference Facilitation |
SD | South Dakota |
sDNA | Stool DNA |
SDV | single dose vial |
SE | Special Edition |
SEI | Software Engineering Institute |
SEP | special enrollment period |
SIA | service intensity add-on |
SME | subject matter expert |
SNF HAI | Skilled Nursing Facility Healthcare Associated Inf |
SNF PDGM | skilled nursing facility patient driven payment mo |
SNF PPS | skilled nursing facility prospective payment syste |
SO | Security Official |
SPADEs | Standardized Patient Assessment Data Elements |
SRS | Stereotactic Radiosurgery |
SSMs | Shared System Maintainers |
STD | sexually transmitted disease |
TBD | to be determined |
TIFF | tagged image file format |
TKA | Total Knee Arthroplasty |
TN | Tennessee |
TPID | Transaction Partner Identifier |
TPL | third party liability |
TPN | total parenteral nutrition |
TRPV1 | transient receptor potential vanilloid |
TX | Texas |
U.S. | United States |
UPIC | Unified Program Integrity Contractor |
URL | Uniform Resource Locator |
USB | universal serial bus |
USPS | United States Postal Service |
USPSTF | United States Preventive Services Task Force |
UT | Utah |
UTN | unique tracking number |
VA | Veterans Affairs |
VA | Virginia |
VAD | ventricular assist device |
VBID | Value-Based Insurance Design |
VBP | Value-Based Purchasing |
VED | vacuum erection device |
VI | Virgin Islands |
VT | Vermont |
WA | Washington |
WI | Wisconsin |
WIA | Wage Index Appeals |
WPC | Washington Publishing Company |
WV | West Virginia |
WY | Wyoming |
APC | Advance Practice Clinician |
CPM | Chronic Pain Management |
DLS | date last seen |
POCT | point of care test |
RSV | respiratory syncytial virus |
IOP | Intensive Outpatient Program |
SWO | standard written order |
SUD | substance use disorder |
CAA 2023 | Consolidated Appropriations Act of 2023 |
EMTALA | Emergency Medical Treatment and Labor Act |
DNA | deoxyribonucleic acid |
RNA | ribonucleic acid |
MFT | marriage and family therapist |
MHC | mental health counselor |
PPEO | Provisional Period of Enhanced Oversight |
SDOH | social determinants of health |
TPE | targeted probe and educate |