Medical Billing and Coding Terminology, Acronyms, & Abbreviations

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Just like any other medical related things, there are a lot of terms, acronyms, and abbreviations in medical billing and coding. If you are an ordinary one, you might not be familiar with these and it might be hard for you to understand as most of them are not common.

If you are planning to take the medical billing and coding courses or if you are one of the patients who have a lot of papers related to medical billing and coding, have zero knowledge about everything on it and want to find out the meaning of everything that is included, you might want to check out the list below:

Medical Billing and Coding Terminology, Acronyms, Abbreviations

  • AAPC: American Academy of Professional Coders
  • ABN: Advance Beneficiary Notice
  • Abuse: The misuse of a person, substance, services such that harm is caused
  • ACA: Affordable care Act
  • Account Number: The number that is handed by the doctor or hospital for a medical visit.
  • AHFS: American Hospital Formulary Service
  • AHIMA: American Healthcare Information Management Association
  • AMA: American Medical Association
  • AOB: Assignment of Benefits
  • ARC: Account Receivable Calling
  • BIL: Bodily Injury Liability
  • BPO: Business Process Outsourcing
  • CCS: Certified Coding Specialist (from AHIMA)
  • CDM: Charges Description Master
  • CF: Conversation Factor
  • CHAMPUS: Civilian Health and Medical Program of the Uniformed Service
  • CHAMPVA: Civilian Health and Medical Program for the Veteran Administration
  • Clearing house: An entity that forwards claims to the insurance companies electronically
  • CLIA: Clinical Laboratory Improvement Amendments
  • CMS: Centers for Medical and Medicaid
  • COB: Co-Ordination of Benefits
  • COBRA: Consolidation Omnibus Budget Reconciliation act
  • CPC: Certified Professional Coder (from AAPC)
  • CPT: Current procedural Terminology
  • DCN: Document Control Number
  • DEERS: Defense Enrollment Eligibility Reporting System
  • DME: Durable Medical Equipment
  • DOB: Date of Birth
  • DOI: Date of Injury
  • DOS: Date of Service (the date when the patient was treated)
  • DRG: diagnosis Related Group
  • DX: Diagnosis Code
  • E & M: Evaluation and Management Services
  • E Codes: External Codes
  • EAP: Employee Assistance Program
  • EDI: Electronic Data Interchange
  • EFT: Electronic Funds Transfer
  • EGHP: Employer Group Health Plan
  • E.H.R. Electronic Health Record
  • EIN: Employer Identification Number
  • EMR: Electronic Medical Records
  • EOB: Explanation of benefits
  • EOMB: Explanation of Medicare Benefits
  • EPO: Exclusive Provider Organization
  • ERA: Electronic Remittance Advice
  • ERISA: employee Retirement Income Security Act
  • ESRD: End Stage Renal Disease
  • FFS: Free For Service
  • FI: Fiscal Intermediary
  • FICA: Federal Insurance Contributions act
  • FIR: First Injury Report
  • Fraud: To purposely bill for services that were never given or to bill for a service that has higher reimbursement than the service provided
  • FSA: Flexible Spending Account
  • Global Days: All surgical services have been assigned a “global time period”, lasting up to a maximum of 90 days, for post-operative care. All follow-up car e for the surgery performed within the assigned global period will be considered part of the surgical reimbursement and not allowed separately.
  • HCFA: Health Care Financing Administration
  • HCPCS: Healthcare Common Procedure Coding System
  • HCRA: Health Care Reform Act
  • HICN: Health Insurance Claim Number
  • HIPAA: Health Insurance Portability and Accountability Act
  • HMO: Health Maintenance Organization
  • ICD: International Classification of Diseases
  • ICN: Internal Control Number
  • IME: Independent Medical Examination
  • Inpatient: A patient who has been admitted to the hospital and stays 24 hours or more.
  • IPA: Independent Practice Association
  • ITES: Information Technology Enable Service (in healthcare sector)
  • KPO: Knowledge Process Outsourcing
  • MB: Medical Billing
  • MCP: Managed Care Plans
  • MHC: Managed Health Care
  • MRN: Medical Record Number
  • MSA: Medical Savings Account
  • MSP: Medicare as a Secondary Payer
  • MVA: Motor Vehicle Accident
  • NCPDP: National Council of Prescriptions Drugs Programs
  • NDC: National Drug Code
  • NEC: Not Elsewhere Classifiable
  • NOS: Not Otherwise Specified
  • NPI: National Provider Identifier
  • NPPES: National Plan and Provider Enumeration system
  • Observation: A kind of service that is used by doctors and hospitals to decide whether the patient needs inpatient hospital care or can recover at home or in an outpatient area. It is usually charged by the hour.
  • OOA: Out of area
  • OON: Out of Network
  • OP: Out Patient
  • Outpatient: A patient who does not have to stay overnight in a hospital. Outpatient services include lab tests-rays and some surgeries.
  • Over-the-counter Drug: The drugs that are available at the pharmacy or at the drug store without prescription from physicians.
  • P-Auth: Pre Authorization
  • PCN: Primary Care Network
  • PCP: Primary Care Physician
  • PDL: Property Damage Liability
  • PHI: Protect Health Information
  • PIN: Provider Identification Number
  • PIP: Personal Injury Protection
  • POS: Place of service (where the actual health services are being performed, whether it is at home, hospital, office or clinic)
  • POS: Point of Service
  • PPO: Preferred Provider Organization
  • PTAN: Provider Transaction Access Number
  • PTFL: Past Timely Filing Limit
  • PX: Procedure Code
  • QMB: Qualified Medicare Beneficiaries
  • RA: Remittance Advice
  • RBRVS: The Resource Based Relative Value Scale
  • RCM: Revenue Cycle Management
  • ROI: Release of Information (a signed statement from patients that allows doctors and hospitals to release medical information so that the insurance companies can pay claims)
  • RVU: Relating Value Unit
  • SNF: Skilled Nursing Facility
  • SOF: Signature On File
  • SSN: Social Security Number
  • Super bill: A form listing the procedures, services and diagnosis codes that is used to record services performed for the patient and the diagnosis of the patient for a given visit.
  • TAR: Treatment Authorization Request
  • TC: Technical Component
  • TCN: Transaction Control Number
  • TFL: Timely Filing Limit
  • TIN: Tax Identification Number
  • TOS: Type of Service
  • TAP: Third Party Administrators
  • UB-92/UB-04: Uniform Billing 92/04
  • UCR: Usual, customary and reasonable
  • UPIN: Unique Physician Identification Number
  • UR: Utilization Review
  • V codes: Vaccination Codes
  • WC: Worker Compensation
  • WO: Write Off
  • ZIP: Zonal Improvement Plan

Those are the most common terminology, acronyms, and abbreviations in medical billing and coding. Aside from these, you might find more of them. In case you do not know the meaning, you are suggested to ask someone that you think knows better about it. If you are not the kind of person who seeks a help from the others or if there is no one to ask, the best thing that you can do is to open your browser and ask the search engine like Google and so on.

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