# Dictionary of Acronyms

Contents

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  [A](#a)   [B](#b)   [C](#c)   [D](#d)   [E](#e)   [F](#f)   [G](#g)   [H](#h)   [I](#i)   [J](#j)   K     [L](#l)   [M](#m)

  [N](#n)   [O](#o)   [P](#p)   [Q](#q)   [R](#r)   [S](#s)   [T](#t)   [U](#u)   [V](#v)   [W](#w)   X     Y         Z
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## A

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  A&D         Admission and Discharge

  AAPC        American Academy of Professional Coders

  AAAHC       American Academy of Accreditation for Health Centers

  ABN         Advanced Beneficiary Notice

  AC          Appeals Council

  ACS         Automated Correspondence System

  ADA         American Dental Association

  ADT         Admission, Discharge, Transfer

  AFDC        Aid to Families with Dependent Children

  AGPAM       American Guild of Patient Account Management

  AHA         American Hospital Association

  AHIMA       American Health Information Management Association

  AHP         Accountable Health Plan

  AHRQ        Agency for Healthcare Research and Quality

  AI/AN       American Indian or Alaskan Native

  AIC         Amount in Controversy

  AIDS        Acquired Immunodeficiency Syndrome

  AIR         All Inclusive Rate

  ALJ         Administrative Law Judge

  AMA         American Medical Association

  AMBU        Ambulatory

  ANSI        American National Standards Institute

  AO          Administrative Officer

  APC         Ambulatory Patient Category or Ambulatory Payment
              Classification

  APG         Ambulatory Patient Group

  A/R or AR   Accounts Receivable

  ARNP        Advanced Registered Nurse Practitioner

  ASC         Ambulatory Surgery Center

  AWP         Average Wholesale Price
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## B

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  BAA         Business Associate Agreement

  BBA         Balanced Budget Act

  BMP         Beneficiary Medial Program

  BOC         Business Office Coordinator
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## C

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  CAH         Critical Access Hospital

  CARF        Commission on Accreditation for Rehabilitation Facilities

  CC          Chief Complaint

  CCN         Claim Control Number

  CDIB        Certificate of Degree of Indian Blood

  CDT         Current Dental Terminology

  CEO         Chief Executive Officer

  CF          Conversion Factor

  CFR         Code of Federal Regulations

  CHAMPUS     Civilian Health and medical Program of the Uniformed
              Services

  CHS         Contract Health Service

  CHSDA       Contract Health Services Delivery Area

  CIF         Claims Inquiry Form

  CIB         Certificate of Indian Blood

  CLIA        Clinical Laboratory Improvement Amendments

  CM          Clinical Modification

  CMHC        Community Mental Health Center

  CMN         Certificate of Medical Necessity

  CMO         Chief Medical Officer

  CMP         Civil Monetary Penalty

  CMS         Centers for Medicare and Medicaid Services (formerly HCFA)

  CNS         Clinical Nurse Specialist

  CO          Commissioned Officer

  COB         Coordination of Benefits

  COBC        Coordination of Benefits Contractor

  COBRA       Consolidated Omnibus Budget Reconciliation Act

  CORF        Comprehensive Outpatient Rehabilitation Facility

  COTS        Commercial-Off-the-Shelf

  CPT         Current Procedural Terminology

  CRNA        Certified Registered Nurse Anesthetist

  CT          Census Track

  CWF         Common Working File

  CY          Calendar Year
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## D

  ----------- -----------------------------------------------------------
  DAB         Departmental Appeals Board

  DCIA        Debt Collection Improvement Act

  DCN         Document Control Number

  DDE         Direct Data Entry (system)

  DEA         Drug Enforcement Agency

  DHHS        see HHS

  DME         Durable Medical Equipment

  DMERC       Durable Medical Equipment Regional Carrier

  DNKA        Did Not Keep Appointment

  DOB         Date of Birth

  DOJ         Department of Justice

  DOS         Date of Service

  DRG         Diagnosis Related Group

  DX          Diagnosis
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## E

  ----------- -----------------------------------------------------------
  E&M         Evaluation and Management

  ECS         Electronic Claims Status

  EDI         Electronic Data Exchange

  EFI         Electronic File Interchange

  EFIO        Electronic File Interchange Organization

  EFT         Electronic Fund Transfer

  EGHP        Employer Group Health Plan

  EHR         Electronic Health Record

  EIN         Employer Identification Number

  EMC         Electronic Media Claim

  EMTALA      Emergency Medical Treatment and Active Labor Act

  EOB         Explanation of Benefits

  EOMB        Explanation of Medicare Benefits

  EPO         Exclusive Provider Organization

  EPSDT       Early Periodic Screening, Diagnosis, and Treatment

  ERA         Electronic Remittance Advice

  ERN         Electronic Remittance Notice

  ESRD        End Stage Renal Disease
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## F

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  FAQ         Frequently Asked Questions

  FCN         Financial Control Number

  FEHB        Federal Employee Health Benefit

  FEP         Federal Employee Program

  FFP         Federal Financial Participation

  FFS         Fee-for-Service

  FI          Fiscal Intermediary

  FMAP        Federal Medical Assistance Percentage

  FMCRA       Federal Medical Care Recovery Act

  FMR         Focused Medical Review

  FMS         Financial Management Service

  FOIA        Freedom of Information Act

  FPL         Federal Poverty Level

  FQHC        Federally Qualified Health Centers

  FRC         Federal Record Center

  FSS         Federal Supply Schedule

  FTC         Federal Trade Commission

  FTP         File Transfer Protocol

  FUD         Follow-up Days

  FY          Fiscal Year
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## G

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  GAAP        Generally Accepted Accounting Principles

  GDRO        Gross Days Revenue Outstanding

  GPCI        Geographic Practice Cost Indices

  GPRA        Government Performance and Results Act

  GUI         Graphical User Interface
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## H

  ----------- -----------------------------------------------------------
  HCFA        Health Care Financing Administration (now CMS)

  HCPCS       Healthcare Common Procedural Coding System

  HEW         Health, Education, and Welfare

  HFS         Host File Server

  HHA         Home Health Agency

  HHS         (Department of) Health and Human Services

  HI          Hospital Insurance

  HIC         Health Insurance Claim

  HICN        Health Insurance Claim Number

  HIM         Health Information Management

  HINNS       Hospital-issued notices of noncoverage

  HIPAA       Health Insurance Portability and Accountability Act

  HIV         Human Immunodeficiency Virus

  HMO         Health Maintenance Organization

  H&P         History and Physical

  HMO         Health Maintenance Organization

  HO          Hearing Officer

  HPI         History of Present Illness

  HPSA        Health Professional Shortage Area
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## I

  ----------- -----------------------------------------------------------
  ICN         Internal Control Number

  ICU         Intensive Care Unit

  IDC-9-CM    International Classification of Diseases, Ninth Revision,
              Clinical Modifications

  IDS         Integrated Delivery System

  IHCIA       Indian Health Care Improvement Act

  IHS         Indian Health Service

  IIHI        Individually Identifiable Health Information

  INPT        Inpatient

  IPA         Independent Practice Association

  ISDEA       Indian Self-Determination and Education Assistance Act of
              1975

  IT          Information Technology

  I/T/U       Indian/Tribal/Urban
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## J

  ----------- -----------------------------------------------------------
  JCAHO       Joint Commission on Accreditation of Healthcare
              Organizations

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## L

  ----------- -----------------------------------------------------------
  LCD         Local Coverage Determination

  LCSW        Licensed Clinical Social Worker
  ----------- -----------------------------------------------------------

## M

  ----------- -----------------------------------------------------------
  MFCC        Marriage, Family, and Child Counselor

  MFT         Marriage and Family Therapists

  MCO         Managed Care Organization

  MHBP        Mail Handlers Benefit Plan

  MOA         Memorandum of Agreement

  MOU         Memorandum of Understanding

  MR          Medical Review

  MRN         Medicare Remittance Notice; also Medicare Redetermination
              Notice

  MSA         Medical Savings Account

  MSE         Medical Screen Examination

  MSN         Medicare Summary Notice

  MSP         Medicare Secondary Payer
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## N

  ----------- -----------------------------------------------------------
  NABP        National Association of Board of Pharmacy

  NAIC        National Association of Insurance Commissioners

  NARA        National Archives and Record Administration

  NBOC        National Business Office Committee

  NCCD        National Committee of Clinical Directors

  NCCI        National Correct Coding Initiative

  NCD         National Coverage Determination

  NCEO        National Chief Executive Officers

  NCHS        National Center for Health Statistics

  NCPDP       National Council for Prescription Drug Program

  NCQA        National Commission for Quality Assurance

  NDC         National Drug Code

  NEC         Not Elsewhere Classified

  NIH         National Institutes of Health

  NP          I National Provider Identifier

  NPIRS       National Patient Information Reporting System

  NOC         Not Otherwise Classified

  NONC        Notice of Non-Coverage

  NOS         Not Otherwise Specified

  NP          Nurse Practitioner

  NPPES       National Plan & Provider Enumeration System

  NPI         National Provider Identifier

  NPMHU       National Postal Mail Handlers Union

  NQF         National Quality Forum

  NUBC        National Uniform Billing Committee

  NUCC        National Uniform Claims Committee
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## O

  ----------- -----------------------------------------------------------
  OBRA        Omnibus Budget Reconciliation Act

  OGC         Office of General Counsel

  OHA         Office of Hearings and Appeals

  OIG         Office of Inspector General

  OIT         Office of Technology

  OMB         Office of Management and Budget

  OPM         Office of Personnel Management

  OPPS        Outpatient Prospective Payment System (Medicare outpatient
              payment)

  ORAP        Office of Resource, Access, and Partnership

  ORF         Outpatient Rehabilitation Facility

  OTR         On-the-record hearing
  ----------- -----------------------------------------------------------

## P

  ----------- -----------------------------------------------------------
  PA          Physician Assistant

  PA-C        Physician Assistant Certified

  PAMS        Patient Account Management System

  PBM         Pharmacy Benefit Manager

  PCC         Patient Care Component of the Resource Patient Management
              System (RPMS)

  PCP         Primary Care Provider

  PCS         Provider Claim Summary, or Procedure Coding System, or
              Patient Care Service

  PDP         Prescription Drug Plan

  PFSH        Past, Family, and/or Social History

  PHI         Protected Health Information; Patient Health Information

  PHO         Preferred Hospital Organization

  PHS         Public Health Service

  PI          Program Integrity or Performance Improvement

  PIN         Provider Identification Number

  PIMS        Patient Information Management System

  PIP         Personal Injury Protection

  POS         Place of Service or Point-of-Sale

  POTR        Preliminary On-the-Record hearing

  PPO         Preferred Provider Organization

  PPS         Prospective Payment System

  PRO         Professional Review Organization (now QIO)

  PT          Physical Therapist
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## Q

  ----------- -----------------------------------------------------------
  QA          Quality Assurance

  QI          Quality Improvement

  QIO         Quality Improvement Organization (formerly PRO)

  QMB         Qualified Medicare Beneficiary
  ----------- -----------------------------------------------------------

## R

  ----------- -----------------------------------------------------------
  RA          Remittance Advice

  RBRVS       Resource Based Relative Value System

  RDF         Renal Dialysis Facility

  RHC         Rural Health Clinic

  RHHI        Regional Home Health Intermediary

  RPMS        Resource Patient Management System

  RO          Regional Office

  ROD         Rollback Detail report

  ROI         Release of Information

  ROS         Review of Systems

  RRB         Railroad Review Board

  RTD         Resubmission Turnaround Document; also Return To Provider

  RTP         Return to Provider

  RV          Relative Value

  RVS         Relative Value Scale

  RVU         Relative Value Unit
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## S

  ----------- -----------------------------------------------------------
  SCHIP       State Children's Health Insurance Program

  SLMB        Specified Low-Income Medicare Beneficiary

  SMI         Supplementary Medical Insurance

  SNF         Skilled Nursing Facility

  SOC         Share of Cost

  SOF         Signature on File

  SRS         Social Rehabilitation Service

  SSA         Social Security Administration

  SSI         Supplemental Security Income

  SSN         Social Security Number
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## T

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  TA          Transitional Assistance

  TAR         Treatment Authorization Request

  TCS         Transaction and Code Sets

  TIN         Tax Identification Number

  TOS         Type of Service

  TPA         Trading Partner Agreement or Third Party Administrator
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## U

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  UCR         Usual, Customary, and Reasonable

  UMWA        United Mine Workers' Association

  UPIN        Unique Provider identification Number

  UPS         Un-interruptible Power Supply

  UR          Utilization Review
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## V

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  VA          Veterans Administration

  VAN         Value-Added Network
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## W

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  WC          Workers' Compensation

  WPC         Washington Publishing Company
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