134 ◾ List of Acronyms
FEC freestanding emergency center
FFS fee for service
FFY federal fiscal year
FI fiscal intermediary
FL Form Locator (see UB-04)
FLSA Fair Labor Standards Act
FMR focused medical review
FMV fair market value
FQHC federally qualified health center
FR Federal Register
FRGs functional related groups
FRNA first registered nurse assistant
FTC Federal Trade Commission
FTP File Transfer Protocol (Internet)
FY fiscal year
GAF geographic adjustment factor
GAO Government Accounting Office
GI gastrointestinal
GMLOS geometric mean length of stay
GPCI Geographic Practice Cost Index
GPO Government Printing Office
GSP global surgical package
H&P history and physical
HCFA Health Care Financing Administration (now CMS)
HCO health care organization
HCPCS Healthcare Common Procedure Coding System
(previously HCFA’s Common Procedure Coding
System)
HFMA Healthcare Financial Management Association
HHA home health agency
HHMCO home health managed care organization
List of Acronyms ◾ 135
HHPPS home health prospective payment system
HHS Health and Human Services
HICN Health Insurance Claim Number
HIM health information management (see also medical
records)
HINNC Hospital Issued Notice of Noncoverage
HIPAA Health Insurance Portability and Accountability Act
(1996)
HMO Health Maintenance Organization
HMOPOS HMO point-of-service (plans)
HOCM high osmolar contrast media (or materials)
HPSA health personnel shortage area
HTML HyperText Markup Language
HTTP HyperText Transfer Protocol (Internet)
HURA health undeserved rural area
HVAC heating, ventilating, air conditioning
HwH hospital within a hospital
I&D incision and drainage
ICD-9-CM International Classification of Diseases, Ninth Revision,
Clinical Modification
ICD-10-CM International Classification of Diseases, Tenth Revision,
Clinical Modification (replacement for ICD-9-CM
Volumes 1 and 2)
ICD-10-PCS ICD-10 Procedure Coding System (replacement for
ICD-9-CM Volume 3)
ICD-11-CM International Classification of Diseases, Eleventh
Revision, Clinical Modification
ICD-11-PCS ICD-11 Procedure Coding System
ICU intensive care unit
IDTF independent diagnostic testing facility
IDS integrated delivery system
IG inspector general
IMD implantable medical device
136 ◾ List of Acronyms
IOL intraocular lens
IP inpatient
IPA independent practice arrangement/association
IRO independent review organization
IRS Internal Revenue Service
IS information systems
ISP Internet service provider
IV intravenous
JCAHO Joint Commission on Accreditation of Healthcare
Organizations
KSAPCs knowledge, skills, abilities and personal
characteristics
LCC lesser of costs or charges
LCD local coverage decision (see also LMRP)
LMRP local medical review policy
LOCMs low osmolar contrast media (or materials)
LOS length of stay
LTCH long-term care hospital (see STACH)
LTRH long-term rehabilitation hospital
MA Medicare Advantage
MAC Medicare administrative contractor
MAC monitored anesthesia care
MAO Medicare Advantage organization
MCE Medicare code editor
MCO managed care organization
MD doctor of medicine
MDH Medicare-dependent hospital
MDS Minimum Data Set
MEI Medicare Economic Index
MFS Medicare Fee Schedule
MIS management information system
MLFS Medicare Laboratory Fee Schedule
List of Acronyms ◾ 137
MMA Medicare Modernization Act (of 2003)
Modem
(Computer)
modulator-demodulator
MOG Medicare Outpatient Grouping
MPFS Medicare Physician Fee Schedule
MRI magnetic resonance imaging
MSA metropolitan statistical area
MS-DOS
(Computer)
Microsoft disk operating system
MS-DRG Medicare Severity DRG (CMS established in 2007)
MSO management service organization
MSO medical staff organization
MSOP market-service-organization-payment
MSP Medicare secondary payer
MUA medically underserved area
MUE medically unlikely edit
MVPS Medicare Volume Performance Standard
NAH Nursing and Allied Health
NCCI National Correct Coding Initiative
NCD National Coverage Decision
NCQA National Committee for Quality Assurance
NCQHC National Committee for Quality Health Care
NF nursing facility
NM nurse midwife
NONC Notice of Noncoverage
NP nurse practitioner (some variation; for instance, ARNP
stands for advanced registered nurse practitioner)
NPP nonphysician provider/practitioner
NSC national supplier clearinghouse
NTIOL new technology intraocular lens
NTIS National Technical Information Service
NUBC National Uniform Billing Committee
138 ◾ List of Acronyms
OASIS Outcome and Assessment Information Set
OBRA Omnibus Reconciliation Act
OCE outpatient code editor
ODS organized delivery system
OIG Office of the Inspector General (see HHS)
OMB Office of Management and Budget
OP outpatient
OPR outpatient payment reform
OR operating room
OT occupational therapy or therapist
OTA occupational therapist assistant
P&P policy and procedure
PA physician assistant
PAM patient accounts manager
PBD provider-based department
PBR Provider-Based Rule (see 42 CFR §413.65)
PCP primary care physician
PE practice expense
PERL (Internet) Practical Extraction and Reporting Language
PET positron emission tomography
PFFS private fee for service
PFS patient financial services
PHI protected health information
PHO physician hospital organization
PMPM per member per month
POS place of service
POS point of service
PPA preferred provider arrangement
PPO preferred provider organization
PPP Point-to-Point Protocol (Internet)
PPR physician payment reform
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