ABBREVIATIONS USED IN EXAM FOR AAPC CRC EXAM
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| RADV | Risk Adjustment Data Validation
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| HHS | Health and Human Services
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| MA | Medicare Advantage
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| HCC | Hierarchical Condition Category
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| IVC | Initial Validation Contractor
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| MEAT | Monitored Evaluated Addressed/Assessed or Treated
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| RAF | Risk Adjustment Factor
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| FFS | Fee For Service
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| HEDIS | Healthcare Effectiveness Data Information Set
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| DME | Durable Medical Equipment
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| PDE | Prescription Drug Event
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| SNP | Special Needs Plans
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| NCQA | National Committee for Quality Assurance
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| CRG | Clinical Risk Grouping
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| CDPS | Chronic Illiness and Disability Payment Systems
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| TANF | Temporary Assistance for Needy Families
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| SSD | Selected Significant Disease
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| HHS-ACA | Health and Human Services - Affordable Care Act
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| MCO | Managed Care Organization
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| RAPS | Risk Adjusting Processing System
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| ACG | Adjusted Clinical Group
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| DCG | Diagnosis Code Value
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| VH | Very High
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| EL | Extra Low
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| DPS | Disability Payment System
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| PMH | Past Medical History
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| MDM | Medical Decision Making
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| AAPC | American Academy of Professional Coders
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| ACR | Adjusted Community Rates
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| ACRP | Adjusted Community Rate Proposal
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| ADS | Alternate Data Sources
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| ADL | Activities of Daily Living
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| AGNS | AT&T Global Network Services
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| AHA | American Hospital Association
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| AHIMA | American Health Information Management Association
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| AMA | American Medical Association
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| ANSI | American National Standards Institute
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| ANSI X12 837 | Variable Length File Format for Electronic Submission of Encounter Data
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| ASC | Ambulatory Surgical Center
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| BBA | Balanced Budget Act of 1997
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| BBRA | Balanced Budget Refinement Act 1999
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| BIC | Beneficiary Identification Code
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| BIPA | Benefits Improvement and Protection Act of 2000
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| CAD | Coronary Artery Disease
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| CFO | Chief Financial Officer
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| CHF | Congestive Heart Failure
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| CMHC | Community Mental Health Center
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| CMS | Centers for Medicare & Medicaid Services
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| CMS-HCC | CMS Refined Hierarchical Condition Category Risk Adjustment Model
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| COPD | Chronic Obstructive Pulmonary Disease
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| CPT | Current Procedural Terminology
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| CSSC | Customer Service and Support Center
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| CVD | Cerebral Vascular Disease
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| CWF | Common Working File
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| CY | Calendar Year
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| DCP | Data Collection Period
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| DDE | Direct Data Entry
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| DHHS | Department of Health and Humana Services
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| DM | Diabetes Mellitus
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| DME | Durable Medical Equipment
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| DOB | Date of Birth
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| DoD | Department of Defense
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| DOS | Dates of Service
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| DRG | Diagnosis Related Group
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| DX | Diagnosis
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| EDI | Electronic Data Interchange
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| ESRD | End Stage Renal Disease
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| ET | Eastern Time
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| FERAS | Front-End Risk Adjustment System
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| FFS | Fee For Service
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| FQHC | Federally Qualified Health Care Center
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| FTP | File Transfer Protocol
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| GUI | Graphical User Interface
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| H# | MA Organizational CMS Contract Number
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| HCC | Hierarchical Condition Category
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| HCFA 1500 | Medicare Part B Claim Filing Form
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| HCPCS | Healthcare Common Procedure Coding System
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| HEDIS | Health Plan Employer Data Information Set
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| HIC# | Health Insurance Claim Number (Beneficiary Medicare ID#)
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| HICN | Health Insurance Claim Number (Beneficiary Medicare ID#)
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| HIPAA | Health Insurance Portability and Accountability Act
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| HMO | Health Maintenance Organization
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| HOS | Health Outcomes Survey
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| HPMS | Health Plan Management System
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| ICD-9-CM | International Classification of Diseases, Ninth Revision, Clinical Modification
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| ICN | Internal Claim Number
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| IP | Internet Protocol
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| IVC | Initial Validation Contractor
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| JCAHO | Joint Commission on Accreditation of Health Care Organization
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| LTC | Leading Through Change, Inc
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| MA | Medicare Advantage
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| MA-PD | Medicare Advantage Prescription Drug Plan
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| MARx | Medicare Advantage Prescription Drug System
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| MBD | Medicare Beneficiary Database
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| M+C organization | Medicare + Choice Organization
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| MCCOY | Managed Care Option Information System
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| MCO | Managed Care Organization
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| MDCN | Medicare Data Communications Network
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| MDS | Minimum Data Set
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| MMA | Medicare Prescription Drug Modernization Act of 2003
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| MMCS | Medicare Managed Care System
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| MMR | Monthly Membership Report
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| MnDHO | Minnesota Disability Health Options
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| MOR | Model Output Report
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| MSA | Medical Savings Account
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| MSG | Message
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| MSHO | Minnesota Disability Health Options
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| NCH | National Claims History
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| NCHS | National Center for Health Statistics
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| NCPDP | National Council on Prescription Drug Program
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| NCQA | National Committee for Quality Assurance
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| NDM | Network Data Mover
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| NEC | Not Elsewhere Classified
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| NMUD | National Medicare Utilization Database
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| NOS | Not Otherwise Specified
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| NPI | National Provider Identifier
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| NSF | National Standard Format
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| OIG | Office of Inspector General
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| OREC | Original Reason for Entitlement Code
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| Palmetto GBA | Palmetto Government Benefits Administrators
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| PACE | Program of All-Inclusive Care for the Elderly
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| PCN | Patient Control Number
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| PHS | PACE Health Survey
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| PIP-DCG | Principal Inpatient Diagnostic Cost Group
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| PPO | Preferred Provider Organization
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| QIO | Quality Improvement Organization
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| RAPS | Risk Adjustment Processing System
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| RAPS Database | Risk Adjustment Processing System Database
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| RAS | Risk Adjustment System
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| RHC | Rural Health Clinic
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| RPT | Report
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| RRB | Railroad Retirement Benefit
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| RT | Record Type
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| RxHCC | Prescription Drug Hierarchical Condition Category
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| SAS | Statistical Analysis Software
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| SCO | MassHealth Senior Care Option
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| SH# | Submitter CMS Contract Number
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| S/HMO | Social Health Maintenance Organizations
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| SNF | Skilled Nursing Facility
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| SSD | Selected Significant Disease Model
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| SSN | Social Security Number
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| SUB ID | Submitter ID
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| SVC | Second Validation Contractor
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| TOB | Type of Bill
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| UB-04 | Uniform Billing Form 04
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| VA | Veterans Administration
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| WPP | Wisconsin Partnership Program
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Created by:
mseverino