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Acronym

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.


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AcronymTerm
AAPCAmerican Academy of Professional Coders
AARPAmerican Association of Retired Persons
ABGarterial blood gas
ABNAdvance Beneficiary Notice of Noncoverage
ACAAffordable Care Act
ACHacute care hospital
ADIadvance diagnostic imaging
ADMCadvanced determination of Medicare coverage
ADPautomated data processing
ADRadditional development request
ADRadditional documentation request
ADSAutomated Development System (Part B letter)
AFOankle-foot orthotic
AICamount in controversy
AIRall-inclusive rate
ALJAdministrative Law Judge
ALOSaverage length of stay
ALSamyotrophic lateral sclerosis
ALSadvanced life support
AMAAmerican Medical Association
ANSIAmerican National Standards Institute
AOBassignment of benefits
APCambulatory payment classification
APSautomated provider screening
ARDassessment reference date
ASCAccredited Standards Committee
ASCambulatory surgical center
ASCAAdministrative Simplification Compliance Act
ASPaverage sales price
ATPassistive technology practitioner or professional
ATSassistive technology supplier
AWPaverage wholesale price
AWVannual wellness visit
BBABalanced Budget Act of 1997
BBRABalanced Budget Refinement Act of 1999
BCRCBenefits Coordination & Recovery Center
BEbenefits exhausted
BIBbreak in billing
BINbreak in need
BIPAMedicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000
BISbreak in service (break-in-service claim)
BIUBenefit Integrity Unit
BLSbasic life support
BMMbone mass measurements
CACCarrier Advisory Committee
CADcomputer-aided design
CAHcritical access hospital
CAMcomputer-aided manufacturing
CAPDcontinuous ambulatory peritoneal dialysis
CARCclaim adjustment reason code
CATcomputerized axial tomography
CBconsolidated billing
CBAcompetitive bidding area
CBICCompetitive Bidding Implementation Contractor
CBSAcore-based statistical area
CBTcomputer-based training
CCcondition code
CCICorrect Coding Initiative
CCNCMS Certification Number
CCNclaim control number
CCPDcontinuous cycling peritoneal dialysis
CCRcost-to-charge ratio
CCRCustomer Care Representative
CDCCERT Documentation Contractor
CDEcertified diabetic educators
CEDICommon Electronic Data Interchange
CELIPclaim expansion and line item processing
CERclaim error rates
CERclerical error reopening
CERTComprehensive Error Rate Testing
CEUcontinuing education units
CFconversion factor
CFOChief Financial Officer
CFRCode of Federal Regulations
CHCcontinuous home care
CHOWchange of ownership
CIDclaim identification number
CLFSclinical laboratory fee schedule
CLIAClinical Laboratory Improvement Amendments
CMDContractor Medical Director
CMGcase-mix group
CMHCcommunity mental health center
CMIcase-mix index
CMNCertificate of Medical Necessity
CMRcomprehensive medical review
CMSCenters for Medicare & Medicaid Services
CMS-­1696Appointment of Representative form
CMS-1450Uniform Bill (UB-04) (for Part A)
CMS-1500Health Insurance Claim Form (for Part B and DME)
CMS-20034Request for Medicare Hearing by an Administrative Law Judge form
CMS-382ESRD Beneficiary Selection form
CMS-460Medicare Participating Physician or Supplier Agreement
CMS-5011BRequest for Part B Medicare Hearing by an Administrative Law Judge form
CMS-588Electronic Funds Transfer (EFT) Authorization Agreement form
CMS-855AMedicare Enrollment Application - Institutional Providers
CMS-855BMedicare Enrollment Application - Clinics/Group Practices and Certain Other Suppliers
CMS-855IMedicare Enrollment Application - Physicians and Nonphysician Practitioners
CMS-855OMedicare Enrollment Application - Registration for Eligible Ordering and Referring Physicians and Nonphysician Practitioners
CMS-855RMedicare Enrollment Application - Reassignment of Medicare Benefits
CMS-855SMedicare Enrollment Application form
CMS-R-131Advance Beneficiary Notice of Noncoverage (ABN) form
CNMcertified nurse midwife
CNScertified nurse specialist
COcentral office (CMS, in Baltimore, MD)
COcontracting officer
COcontractual obligation
COBcoordination of benefits
COBCCoordination of Benefits Contractor
COBRAConsolidation Omnibus Budget Reconciliation Act of 1986
COLAcost of living adjustment
COPconditions of participation
COPDchronic obstructive pulmonary disease
CORFcomprehensive outpatient rehabilitation facility
CPclinical psychologist
CPAPcontinuous positive airway pressure
CPIconsumer price index
CPOcare plan oversight
CPTclaims processing timeliness
CPT/CPT-4current procedural terminology
CQMclinical quality measures
CRChange Request
CRCCERT Review Contractor
CRCCommercial Repayment Center
CRNAcertified registered nurse anesthetist
CSIClaim Status Inquiry
CSWclinical social workers
CTcentral time
CTIcertification of terminal illness
CWFCommon Working File (also known as HIMR)
CYcalendar year
DABdepartmental appeals board
DCNdocument control number
DDEDirect Data Entry
DGMEdirect graduate medical education
DHHSDepartment of Health and Human Services (also referred to as HHS)
DIFDME Information Form
DMEdurable medical equipment
DME MACDurable Medical Equipment Medicare Administrative Contractor
DMECSDurable Medical Equipment Coding System
DMEPOSdurable medical equipment prosthetics, orthotics and supplies
DMERCdurable medical equipment regional carrier
DNFdo not forward
DOdoctor of osteopathy
DOAdate of accident
DOAdate of accretion
DOBdate of birth
DODdate of death
DOJDepartment of Justice
DOLDepartment of Labor
DOSdate of service
DPAdual photon absorptiometry
DPMdoctor of podiatric medicine
DPUdistinct-part unit
DRADeficit Reduction Act of 2005
DRGdiagnosis-related group
DSHdisproportionate share hospital
DSMTdiabetes self-management training
DWOdetailed written order
E/Mevaluation and management
ECTelectroconvulsive therapy
EDCenterprise data center
EDIElectronic data interchange
EEGelectroencephalogram
EFTelectronic funds transfer
EGHPemployer group health plan
EHRelectronic health record
EINEmployer Identification Number
ELGAEligibility Inquiry Part A
EMCelectronic media claim
EMRelectronic medical record
EOBexplanation of benefits
EPeligible professional
EPOepoetin
ERemergency room
ERAelectronic remittance advice
ESAerythropoiesis stimulating agent
esMDelectronic submission of medical documentation
ESRDend-stage renal disease
ETeastern time
FAQfrequently asked question
FASTfunctional assessment staging
FBIFederal Bureau of Investigation
FCNfinancial control number
FDAFood & Drug Administration
FECAFederal Employee Compensation Act
FFSfee for service
FIFiscal Intermediary
FISSFiscal Intermediary Standard System (processing system for Part A)
FLField Locator
FLForm Locator
FMRfocused medical review
FOIFreedom of Information
FOIAFreedom of Information Act
FQHCfederally qualified health center
FTEfull-time equivalent
FTEfull-time employee
FYfiscal year
GAFgeographic adjustment factor
GAOGeneral Accounting Office; or Government Accountability Office
GHPgroup health plan
GIPGeneral inpatient care
GMEgraduate medical education
GPCIgeographic practice cost index
GPOU.S. Government Printing Office
HBVHepatitis B Virus
HCOhigh cost outlier
HCPCSHealthcare Common Procedure Coding System
HETSHIPAA Eligibility Transaction System
HH+Hhome health plus hospice
HHAhome health agency
HHHhome health and hospice
HHPPShome health prospective payment system
HHRGhome health resource group
HHSUnited States Department of Health and Human Services
HIBChigh intensity behavioral counseling
HICHealth Insurance Claim (Number)
HICNHealth Insurance Claim Number
HIGLASHealthcare Integrated General Ledger Accounting System
HIHhealth information handler
HIMRHealth Insurance Master Record (also known as CWF)
HIPAAHealth Insurance Portability and Accountability Act
HIPPShealth insurance prospective payment system (code)
HIQAHealth Insurance Query Access (CWF)
HIQHhealth insurance query for home health agencies
HIVhuman immunodeficiency virus
HMEhome medical equipment
HMOhealth maintenance organization
HPIDhealth plan identifier
HPSAhealth professional shortage area
HQRPHospice Quality Reporting Program
HRSAHealth Resources & Services Administration
HSQBHealth Standards Quality Bureau
I/OCEIntegrated Outpatient Code Editor
IACS-PCIndividuals Authorized Access to CMS Computer Services—Provider Community
IBTintensive behavioral therapy
ICD-10-CMInternational Classification of Diseases, Clinical Modification, 10th Revision
ICD-9-CMInternational Classification of Diseases, Clinical Modification, 9th Revision
ICFintermediate care facility
ICNinternal control number
IDidentification
IDGinterdisciplinary group
IDTFindependent diagnostic testing facility
IGInspector General
IICinflation-indexed charge
IMEindirect medical education
IOM(CMS) Internet-Only Manual
IPinpatient
IPFinpatient psychiatric facility
IPPindirect payment procedure
IPPindirect payment procedure
IPPEinitial physical preventive examination
IPPSinpatient prospective payment system
IRFinpatient rehabilitation facility
IRPinexpensive or other routinely purchased DME
IRSInternal Revenue Service
IRVENinpatient rehabilitation validation and entry
IVintravenous
IVRinteractive voice response (system)
J6Jurisdiction 6 A/B Medicare Administrative Contractor
JBJurisdiction B Durable Medical Equipment Medicare Administrative Contractor
JKJurisdiction K A/B Medicare Administrative Contractor
JSMJoint Signature Memorandum
KAFOknee-ankle foot orthotic
KPSKarnofsky Performance Status (Scale)
LCDlocal coverage determination
LCLlowest charge level
LCMPlicensed clinical medical professional
LCSWlicensed clinical social worker
LDCTlow-dose computed tomography
LGHPlarge group health plan
LICSWlicensed independent clinical social worker
LIDOSline item date of service
LIPlow income payment
LOClevel of care
LOSlength of stay
LPMliters per minute
LPNlicensed practical nurse
LSOlumbar-sacral orthosis
LSOlocal security officer
LTC DRGlong-term care diagnosis-related group
LTCHlong-term care hospital
LTRlifetime reserve (days)
LUPAlow utilization payment adjustment
MACMedicare Administrative Contractor
MACMedicare appeals council
MAEmobility assistive equipment
MAIMUE adjudication indicator
MAOMedicare Advantage organization
MBIMedicare Beneficiary Identifier
MCDMedicare Coverage Database
MCEMedicare code editor
MCFUMedicaid Fraud Control Units
MCPSSMedicare contractor provider satisfaction survey
MCSMulti-Carrier System (processing system for Medicare Part B)
MCTRJCAMiddle Class Tax Relief and Job Creation Act
MDdoctor of medicine
MDHMedicare dependent hospital
MDPPMedicare Diabetes Prevention Program
MDSminimum data set
MEDAMedicare Part A
MEDPARDMedicare Participating Physician/Supplier Directory
MFAmulti-factor authentication
MHOMedicare hearing officer
MIPMedicare Integrity Program
MLNMedicare Learning Network
MMMLN Matters
MMAMedicare Modernization Act of 2003
MNTmedical nutrition therapy
MPDIMAMedicare Prescription Drug, Improvement, and Modernization Act of 2003
MPFSMedicare physician fee schedule
MPFSDBMedicare physician fee schedule database
MPPRmultiple procedure payment reduction
MQSAMammography Quality Standards Act
MRMedical Review
MRAMedicare remittance advice
MREPMedicare Remit Easy Print (software)
MRImagnetic resonance imaging
MRNMedicare redetermination notice
MSAmetropolitan statistical area
MSAmedical service area
MSNMedicare Summary Notice
MSPMedicare Secondary Payer
MSPRCMedicare Secondary Payer Recovery Contractor
MUMedicare University
MUCMedicare University Credit
MUEmedically unlikely edit
N&AHnursing and allied health
NCCINational Correct Coding Initiative
NCDnational coverage determination
NCHNational Claims History (System)
NCPDPNational Council for Prescription Drug Programs
NDCnational drug code
NFnursing facility
NFPPNational Fraud Prevention Program
NHPCSNational Hospice and Palliative Care Organization
NMONational Mail Order (Program)
NOCnot otherwise classified (code)
NOEnotice of election
NON PARnonparticipating provider
NOSnot otherwise specified
NPnurse practitioner
NPINational Provider Identifier
NPPnonphysician practitioner
NPPESNational Plan and Provider Enumeration System
NPWTnegative pressure wound therapy
NSCNational Supplier Clearinghouse
NSFnational standard format
NTEnote
NUBCNational Uniform Billing Committee
NUCCNational Uniform Claim Committee
OASOffice of Audit Service (of the Department of Health and Human Services)
OASISOutcome and Assessment Information Set
OBRAOmnibus Budget Reconciliation Act
OCoccurrence code
OCEoutpatient code editor
OCIGOffice of Counsel to the Inspector General
OCRoptical character recognition
ODoptometrist (doctor of optometry)
OEIDother entity identifier
OIOffice of Investigations
OIFOOffice of Investigations Field Office (OIG)
OIGOffice of Inspector General
OMBOffice of Management and Budget
OPoutpatient
OPPSoutpatient prospective payment system
ORFoutpatient rehabilitation facility
ORUOverpayment Recovery Unit
OSCoccurrence span code
OSCAROnline Survey, Certification and Reporting (OSCAR System)
OToccupational therapist
OToccupational therapy
OTAFobligated to accept as payment in full
OTRon-the-record hearing
P&Oprosthetic and orthotic
PAphysician assistant
PApolicy article
PACEProgram of All-Inclusive Care for the Elderly
PAIpatient assessment instrument
PAPpositive airway pressure
PARparticipating provider
PCAprogressive corrective action
PCCProvider Contact Center
PCIPPrimary Care Incentive Program
PCSPhysician Certification Statement
PDACPricing, Data Analysis and Coding (Contractor)
PDFportable document format
PECOSProvider Enrollment, Chain and Ownership System
PENparenteral and enteral nutrition
PEPPartial episode payment
PERPayment error rates
PFSPhysician fee schedule
PHIprotected health information
PHSPublic Health Services
PIIpersonally identifiable information
PINProvider Identification Number
PIPPeriodic interim payment
PMDpower mobility device
POPoint of origin
POCPlan of care
POEProvider outreach and education
POE AGProvider Outreach and Education Advisory Group
POSplace of service
POTRPreliminary on-the-record hearing
POVpower-operated vehicle
PPACAPatient Protection and Affordable Care Act
PPOPreferred provider organization
PPSprospective payment system
PPSpalliative performance score
PPTNProfessional Provider Telecommunications Network
PPVPneumococcal pneumonia vaccine
PQRIPhysician Quality Reporting Initiative
PQRSPhysician Quality Reporting System
PRpatient responsibility
PRMProvider Reimbursement Manual (Medicare Publication 15-1/15-2)
PRNpro re nata (as needed)
PRRSProvider relations research specialist
PS&RProvider Statistical & Reimbursement Report
PSCprogram safeguard contractor
PSCpatient status code
PTphysical therapist
PTphysical therapy
PTpacific time
PTANProvider Transaction Access Number
PTPprocedure-to-procedure
PWCpower wheelchair
QCDRQualified clinical data registry
QICQualified independent contractor
QIOQuality improvement organization
QMBQualified Medicare Beneficiary
QRQuick response (CMS-1500 code symbol)
R&Nresonable and necessary
RAremittance advice
RARecovery Auditor
RACrecovery audit contractor
RADrespiratory assist devices
RAPRequest for anticipated payment
RARCremittance advice remark codes
RBRVUResource-based relative value unit
RCrevenue code/reason code
RDFRenal dialysis facility
RESNARehabilitation Engineering and Assistive Technology of North America
RFARegulatory Flexibility Act
RHCRural health clinic
RHCRoutine home care
RHHIRegional home health intermediary
RICRehabilitation impairment category
RICORacketeering Influenced Corrupt Organization
RNRegistered nurse
RNHCIReligious nonmedical health care institution
RORegional office (CMS)
RRCRural Referral Center
RTPreturn to provider
RUGResource utilization group
RULReasonable useful lifetime
RVURelative value unit
S/LOCstatus/location
SADMERCStatistical Analysis DMERC (now referred to as the PDAC)
SCHsole community hospital
SCHIPState Children’s Health Insurance Program
SERservice error rates
SGRsustainable growth rate
SHIPState Health Insurance Assistance Program
SIAsupplemental instruction article
SLPspeech-language pathology
SMRCSupplemental Medical Review Contractor
SMRCSpecialty Medical Review Contractor
SNFSkilled nursing facility
SOBshortness of breath
SPAsingle payment amount
SPRstandard paper remittance
SSASocial Security Administration
SSIsupplemental security income
SSNSocial Security Number
STIsexually transmitted infections
TCMtransitional care management
TDD telecommunication device
TEFRATax Equity and Fiscal Responsibility Act of 1982
TENSTranscutaneous electrical nerve stimulator
TINTax Identification Number
TLSOthoracic-lumbar-sacral orthosis
TMRtargeted medical review
TOBtype of bill
TPEtargeted probe and educate
TRUTelephone Reopening Unit
TTY text telephone
UBuniform bill
UOSunit of service
UPINUnique Physician Identification Number
VAVeterans Administration
VAVeterans Affairs
VCvalue code
VMSViPS Medicare System
VTCvideo teleconference
WACwholesale acquisition cost
WCworkers’ compensation
WOPDwritten order prior to delivery
YTDyear to date
ZPICzone program integrity contractor
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