Medical Terms for Billing and Coding


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A
   ablation
   abstract
   abuse
   access
   accessibility of services
   accessory dwelling unit (adu)
   accreditation
   accreditation cycle for m-c deeming
   accreditation for deeming
   accreditation for participation
   accredited (accreditation)
   accredited standards committee
   act, law, statute
   activities of daily living (adl)
   actual charge
   actuarial balance
   actuarial deficit
   actuarial rates
   actuarial soundness
   actuarial status
   acupuncture
   acute
   add-on-code
   additional benefits
   adjusted average per capita cost (aapcc)
   adjusted community rating (acr)
   administrative code sets
   administrative costs
   administrative data
   administrative expenses
   administrative law judge (alj)
   administrative services only
   administrative simplification
   administrative simplification compliance act
   administrator
   admission date
   admitting diagnosis code
   admitting physician
   adult living care facility
   advanced contract billing codes(abc codes)
   advance beneficiary notice (abn)
   advance coverage decision
   advance directives
   advance directive (health care)
   adverse effects
   advisory council on social security
   advocate
   affiliated contractor
   affiliated provider
   aged enrollee
   albumin
   algorithm
   allowed charge
   ambulance (air or water)
   ambulance (land)
   ambulatory
   ambulatory care
   ambulatory care sensitive conditions
   ambulatory surgical center
   AMENDMENTS AND CORRECTIONS
   AMERICAN ASSOCIATION FOR HOMECARE
   AMERICAN DENTAL ASSOCIATION
   AMERICAN HEALTH INFORMATION MANAGEMENT ASSOCIATION
   AMERICAN HOSPITAL ASSOCIATION
   AMERICAN INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS
   AMERICAN MEDICAL ASSOCIATION
   AMERICAN MEDICAL INFORMATICS ASSOCIATION
   AMERICAN NATIONAL STANDARDS
   AMERICAN NATIONAL STANDARDS INSTITUTE
   AMERICAN SOCIETY FOR TESTING AND MATERIALS
   AMNIOCENTESIS
   AMORTIZATION
   AMPUTATION
   ANALGESIC
   ANASTOMOSIS
   ANCILLARY SERVICES
   ANEMIA
   ANESTHESIA
   ANGIODYSPLASIA
   ANNUAL ELECTION PERIOD
   ANTIBODY (AB)
   antigen (ag)
   appeal
   appeal process
   APPROVED AMOUNT
   ARCTATION (COARCTATION)
   AREA AGENCY ON AGING (AAA)
   ARTERY
   ARTHROCENTESIS
   ARTHRODESIS
   ARTHROPLASTY
   ASPHYXIA
   aspiration
   assessment
   assets
   assigned claim
   assignment
   assisted living
   association for electronic health care transactions
   assumptions
   attachment(s)
   attending physician
   authoritative approval
   authoritative evidence
   authorization
   automated claim review
   average market yield

B
   BABY BOOM
   BALANCE BILLING
   BASE ESTIMATE
   BASIC BENEFITS
   BASIC BENEFITS (MEDIGAP POLICY)
   BENCHMARK
   BENEFICIARY
   BENEFICIARY ENCRYPTED FILE
   BENEFICIARY NOTIFICATION LETTER
   BENEFITS
   BENEFITS DESCRIPTION (PLAN)
   BENEFIT PAYMENTS
   BENEFIT PERIOD
   BIOLOGICALS
   BIOMETRIC IDENTIFIER
   BIRTHING CENTER
   BLOOD UREA NITROGEN
   BLUE CROSS AND BLUE SHIELD ASSOCIATION
   BOARD-CERTIFIED
   BOARD AND CARE HOME
   BOARD HEARING
   BOARD OF TRUSTEES
   BODY RECORD
   BOND
   BONUS
   BUSINESS ASSOCIATE
   BUSINESS MODEL
   BUSINESS PARTNER
   BUSINESS RELATIONSHIPS

C
   CADAVERIC TRANSPLANT
   CALLABLE
   CAPITATION
   CAPPED RENTAL ITEM
   CAREGIVER
   CARE PLAN
   CARRIER
   CASE MANAGEMENT
   CASE MANAGER
   CASE MIX
   CASE MIX INDEX
   CASH BASIS
   CATASTROPHIC ILLNESS
   CATASTROPHIC LIMIT
   CENTERS FOR DISEASE CONTROL AND PREVENTION
   CENTER FOR HEALTHCARE INFORMATION MANAGEMENT
   CERTIFICATE OF INDEBTEDNESS
   CERTIFICATE OF MEDICAL NECESSITY
   CERTIFIED (CERTIFICATION)
   CERTIFIED NURSING ASSISTANT (CNA)
   CERTIFIED REGISTERED NURSE ANESTHETIST
   CHAIN OF TRUST
   CHAIN OF TRUST AGREEMENT
   CHRONIC MAINTENANCE DIALYSIS
   CIVILIAN HEALTH AND MEDICAL PROGRAM (CHAMPUS)
   CLAIM
   CLAIM ADJUSTMENT REASON CODES
   CLAIM ATTACHMENT
   CLAIM STATUS CATEGORY CODES
   CLAIM STATUS CODES
   CLINICAL BREAST EXAM
   CLINICAL PERFORMANCE MEASURE
   CLINICAL PRACTICE GUIDELINES
   CLINICAL TRIALS
   CMS-1450
   CMS-1500
   CMS AGENT
   CMS DIRECTED IMPROVEMENT PROCESS
   CODE OF FEDERAL REGULATIONS
   CODE SET
   CODE SET MAINTAINING ORGANIZATION
   COGNITIVE IMPAIRMENT
   COHORT
   COINSURANCE (MEDICARE PRIVATE FEE-FOR-SERVICE PLAN)
   COINSURANCE (OUTPATIENT PROSPECTIVE PAYMENT SYSTEM)
   COLLEGE OF HEALTHCARE INFORMATION MANAGEMENT EXECUTIVES
   COMMENT
   COMMERCIAL MCO
   COMMUNITY MENTAL HEALTH CENTER
   COMPLAINT
   COMPLAINT (OF FRAUD OR ABUSE)
   COMPLIANCE DATE
   COMPREHENSIVE INPATIENT REHABILITATION FACILITY
   COMPREHENSIVE MCO
   COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY
   COMPREHENSIVE OUTPATIENT REHABILITATION FACILITY (CORF)
   COMPUTER-BASED PATIENT RECORD INSTITUTE-HEALTHCARE OPEN SYSTEMS AND TRIALS
   COMPUTER MATCHING AGREEMENT
   CONDITIONAL PAYMENT
   CONFIDENTIALITY
   CONSENT AND AUTHORIZATION (BASIC RULE)
   CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT (COBRA)
   CONSUMER ASSESSMENT OF HEALTH PLANS STUDY (CAHPS)
   CONSUMER PRICE INDEX
   CONSUMER SELF-REPORT DATA
   CONSUMER SURVEY DATA
   CONTINGENCY
   CONTINGENCY MARGIN
   CONTINUATION OF ENROLLMENT
   CONTINUING CARE RETIREMENT COMMUNITY (CCRC)
   CONTINUOUS AMBULATORY PERITONEAL DIALYSIS
   CONTINUOUS CYCLING PERITONEAL DIALYSIS
   CONTINUOUS QUALITY IMPROVEMENT
   CONTRACTOR
   CONTRIBUTIONS
   CONTRIBUTION BASE
   COORDINATED CARE PLAN
   COORDINATION OF BENEFITS
   COORDINATION PERIOD
   COST-BASED HEALTH MAINTENANCE ORGANIZATION
   COST RATE
   COST REPORT
   COST SHARING
   COVERAGE ANALYSIS FOR LABORATORIES (CALS)
   COVERAGE BASIS
   COVERAGE ISSUES MANUAL (CIM)
   COVERED BENEFIT
   COVERED CHARGES
   COVERED EARNINGS
   COVERED EMPLOYMENT
   COVERED ENTITY
   COVERED FUNCTION
   COVERED SERVICES
   COVERED WORKER
   CREDITABLE COVERAGE
   CRITERIA
   CRITICAL ACCESS HOSPITAL
   CROSSWALKING
   CURRENT DENTAL TERMINOLOGY
   CURRENT PROCEDURAL TERMINOLOGY
   CUSTODIAL CARE
   CUSTODIAN

D
   D-CODES
   DATA CONDITION
   DATA CONTENT
   DATA COUNCIL
   DATA DICTIONARY
   DATA ELEMENT
   DATA EXTRACT SYSTEM ACCESS FORM
   DATA INTERCHANGE STANDARDS ASSOCIATION
   DATA MAPPING
   DATA MODEL
   DATA SUPPORT ACCESS FACILITY ACCESS FORM
   DATA USE AGREEMENT
   DATA USE CHECKLIST
   DATE OF FILING AND DATE OF SUBMISSION
   DATE OF RECEIPT
   DEDUCTIBLE (MEDICARE)
   DEEMED
   DEEMED STATUS
   DEEMED WAGE CREDIT
   DEEMING AUTHORITY
   DEFICIENCY (NURSING HOME)
   DEHYDRATION
   DEMOGRAPHIC ASSUMPTIONS
   DEMOGRAPHIC DATA
   DEMONSTRATIONS
   DENTAL CONTENT COMMITTEE
   DEPARTMENT OF HEALTH AND HUMAN SERVICES
   DERIVATIVE FILE
   DESCRIPTOR
   DESIGNATED CODE SET
   DESIGNATED DATA CONTENT COMMITTEE OR DESIGNATED DCC
   DESIGNATED STANDARD
   DESIGNATED STANDARD MAINTENANCE ORGANIZATION
   DETERMINATION
   DIABETIC DURABLE MEDICAL EQUIPMENT
   DIAGNOSIS-RELATED GROUPS
   DIAGNOSIS
   DIAGNOSIS CODE
   DIALYSATE
   DIALYSIS
   DIALYSIS CENTER (RENAL)
   DIALYSIS FACILITY (RENAL)
   DIALYSIS STATION
   DIETHYLSTILBESTROL (DES)
   DIGITAL IMAGING AND COMMUNICATIONS IN MEDICINE
   DIRECT DATA ENTRY
   DISABILITY
   DISABILITY INSURANCE
   DISABLED ENROLLEE
   DISCHARGE PLANNING
   DISCLOSURE
   DISCLOSURE HISTORY
   DISCOUNT DRUG LIST
   DISCRETIONARY SPENDING
   DISENROLL
   DISPROPORTIONATE SHARE HOSPITAL
   DOWNCODE
   DRAFT STANDARD FOR TRIAL USE
   DRG CODING
   DRUG TIERS
   DUAL ELIGIBLES
   DURABLE MEDICAL EQUIPMENT
   DURABLE MEDICAL EQUIPMENT REGIONAL CARRIER (DMERC)
   DURABLE POWER OF ATTORNEY

E
   EARNINGS
   ECONOMIC ASSUMPTIONS
   ECONOMIC STABILIZATION PROGRAM
   EDIT
   EDI TRANSLATOR
   EFFECTIVE
   EFFECTIVE DATE
   EFFICIENT
   ELDERCARE
   ELECTION
   ELECTION PERIODS
   ELECTRONIC COMMERCE
   ELECTRONIC DATA INTERCHANGE
   ELECTRONIC HEALTHCARE NETWORK ACCREDITATION COMMISSION
   ELECTRONIC MEDIA CLAIMS
   ELECTRONIC MEDIA QUESTIONNAIRE
   ELECTRONIC REMITTANCE ADVICE
   ELIGIBILITY
   ELIGIBILITY or MEDICARE PART A
   ELIGIBILITY or MEDICARE PART B
   EMERGENCY CARE
   EMERGENCY ROOM (HOSPITAL)
   EMPLOYEE
   EMPLOYER
   EMPLOYER BULLETIN BOARD SERVICE
   EMPLOYER GROUP HEALTH PLAN (GHP)
   EMPLOYER IDENTIFIER
   EMT-BASIC
   EMT-INTERMEDIATE
   EMT-PARAMEDIC
   EMTALA (EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT)
   ENCOUNTER DATA
   END-STAGE RENAL DISEASE
   END-STAGE RENAL DISEASE (ESRD)
   END-STAGE RENAL DISEASE NETWORK
   END STAGE RENAL DISEASE TREATMENT FACILITY
   ENHANCED BENEFITS
   ENROLL
   ENROLLEE HOTLINES
   ENROLLMENT
   ENROLLMENT - PART A
   ENROLLMENT FEE
   ENROLLMENT PERIOD
   ENTITY ASSETS
   EPISODE
   EPISODE OF CARE
   EQRO ORGANIZATION
   EQUIVALENCY REVIEW
   ESRD ELIGIBILITY REQUIREMENTS
   ESRD FACILITY
   ESRD NETWORK
   ESRD NETWORK ORGANIZATION
   ESRD PATIENT
   ESRD SERVICES
   EVIDENCE
   EVIDENCE OF FUNDING
   EXCESS CHARGES
   EXCLUSIONS (MEDICARE)
   EXPEDITED APPEAL
   EXPEDITED ORGANIZATION DETERMINATION
   EXPENDITURE
   EXPENSE
   EXTENDED CARE SERVICES
   EXTERNAL QUALITY REVIEW ORGANIZATION

F
   FACILITY CHARGE
   FALSE NEGATIVES
   FALSE POSITIVES
   FEDERALLY QUALIFIED HEALTH CENTER
   FEDERALLY QUALIFIED HEALTH CENTER (FQHC)
   FEDERAL GENERAL REVENUES
   FEDERAL INSURANCE CONTRIBUTIONS ACT
   FEDERAL INSURANCE CONTRIBUTION ACT PAYROLL TAX
   FEDERAL MANAGERS' FINANCIAL INTEGRITY ACT
   FEDERAL MEDICAL ASSISTANCE PERCENTAGE
   FEDERAL REGISTER
   FEE-FOR-SERVICES
   FEE-SCREEN YEAR
   FEE SCHEDULE
   FINANCIAL DATA
   FINANCIAL INTERCHANGE
   FIRST RESPONDER
   FISCAL INTERMEDIARY
   FISCAL YEAR
   FIXED CAPITAL ASSETS
   FLAT FILE
   FOCUSED STUDIES
   FORMAT
   FORMULARY
   FORMULARY DRUGS
   FRAUD
   FRAUD AND ABUSE
   FREEDOM OF INFORMATION ACT
   FREEDOM OF INFORMATION ACT (FOIA)
   FREE LOOK (MEDIGAP POLICY)
   FREQUENCY DISTRIBUTION
   FULLY ACCREDITED
   FULL CAPITATION
   FULL CAPITATION (FUL)
   FULL PSC OR FULL PROGRAM SAFEGUARD CONTRACTOR

G
   GAPFILLING
   GAPS
   GATEKEEPER
   GENERAL ENROLLMENT PERIOD (GEP)
   GENERAL FUND OF THE TREASURY
   GENERAL REVENUE
   GRIEVANCES AND COMPLAINTS
   GROSS DOMESTIC PRODUCT
   GROUP HEALTH PLAN
   GROUP OR NETWORK HMO
   GUARANTEED ISSUE RIGHTS (ALSO CALLED MEDIGAP PROTECTIONS)
   GUARANTEED RENEWABLE
   GUIDELINES

H
   HCFA-1450
   HCFA-1500
   HEALTHCARE COMMON PROCEDURAL CODING SYSTEM
   HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION
   HEALTHCARE PROVIDER TAXONOMY CODES
   HEALTH CARE CLEARINGHOUSE
   HEALTH CARE CODE MAINTENANCE COMMITTEE
   HEALTH CARE FINANCING ADMINISTRATION DATA MA
   HEALTH CARE PREPAYMENT PLAN
   HEALTH CARE PROVIDER
   HEALTH CARE PROVIDER TAXONOMY COMMITTEE
   HEALTH CARE QUALITY IMPROVEMENT PROGRAM
   HEALTH EMPLOYER DATA AND INFORMATION SET (HEDIS)
   HEALTH INFORMATICS STANDARDS BOARD
   HEALTH INSURANCE ASSOCIATION OF AMERICA
   HEALTH INSURANCE CLAIMS NUMBER
   HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)
   HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996
   HEALTH INSURING ORGANIZATION
   HEALTH LEVEL SEVEN
   HEALTH MAINTENANCE ORGANIZATIONS (HMO)
   HEALTH PLAN
   HEARING
   HEDIS MEASURES FROM ENCOUNTER DATA
   HEMATOCRIT
   HEMODIAFILTRATION
   HEMODIALYSIS
   HEMODIALYSIS (HD)
   HEMOFILTRATION
   HIGH COST ALTERNATIVE
   HIGH RISK AREA
   HIPAA DATA DICTIONARY OR HIPAA DD
   HOME
   HOMEBOUND
   HOME AND COMMUNITY-BASED SERVICE WAIVER PROGRAMS (HCBS)
   HOME HEALTH AGENCY
   HOME HEALTH CARE
   HOME PATIENTS
   HOSPICE
   HOSPICE CARE
   HOSPITALIST
   HOSPITAL ASSUMPTIONS
   HOSPITAL COINSURANCE
   HOSPITAL INDEMNITY INSURANCE
   HOSPITAL INPUT PRICE INDEX
   HOSPITAL INSURANCE
   HOSPITAL INSURANCE (PART A)
   HOSPITAL MARKET BASKET
   HYBRID ENTITY
   HYDRATION

I
   ICD, ICD-N-CM, ICD-N-PCS
   IMMUNOSUPPRESSIVE DRUGS
   IMPLEMENTATION GUIDE
   IMPLEMENTATION SPECIFICATION
   IMPROVEMENT PLAN
   INAPPROPRIATE UTILIZATION
   INCIDENCE
   INCOME RATE
   INCURRED BASIS
   INDEPENDENT LABORATORY
   INDICATOR
   INFORMATION, COUNSELING, AND ASSISTANCE PROGRAM
   INFORMATION MODEL
   INFUSION PUMPS
   INITIAL (CLAIM) DETERMINATION
   INITIAL COVERAGE ELECTION PERIOD
   INITIAL ENROLLMENT PERIOD
   INITIAL ENROLLMENT QUESTIONNAIRE (IEQ)
   INPATIENT CARE
   INPATIENT HOSPITAL
   INPATIENT HOSPITAL DEDUCTIBLE
   INPATIENT HOSPITAL SERVICES
   INPATIENT PSYCHIATRIC FACILITY
   INSOLVENCY
   INSURER
   INTEREST
   INTERFUND BORROWING
   INTERMEDIARY
   INTERMEDIARY HEARING
   INTERMEDIARY OR PROGRAM SAFEGUARD CONTRACTOR DETERMINATION
   INTERMEDIATE CARE FACILITY OR MENTALLY RETARDED
   INTERMEDIATE ENTITIES
   INTERMITTENT PERITONEAL DIALYSIS
   INTERNAL CONTROLS
   INTERNAL REVENUE SERVICE
   INTERNATIONAL CLASSIFICATION OF DISEASES
   INTERNATIONAL ORGANIZATION FOR STANDARDIZATION
   INTERNIST
   INTER OR INTRA AGENCY AGREEMENT
   INTRAGOVERNMENTAL ASSETS, LIABILITIES

J
   J-CODES
   JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS

L
   LARGE GROUP HEALTH PLAN
   LETTER OF REQUEST
   LETTER OF SUPPORT
   LIABILITY DETERMINATION
   LIABILITY INSURANCE
   LICENSED (LICENSURE)
   LICENSED BY THE STATE AS A RISK-BEARING ENTITY
   LIFETIME RESERVE DAYS
   LIFETIME RESERVE DAYS (MEDICARE)
   LIMITING CHARGE
   LINE ITEM
   LIVING DONOR KIDNEY TRANSPLANT
   LIVING WILLS
   LMRP ARTICLES
   LOCAL CODE(S)
   LOCAL CODES
   LOCAL COVERAGE DETERMINATION (LCD)
   LOCAL MEDICAL REVIEW POLICY (LMRP)
   LOGICAL OBSERVATION IDENTIFIERS, NAMES AND CODES
   LONG-TERM CARE
   LONG-TERM CARE INSURANCE
   LONG-TERM CARE OMBUDSMAN
   LONGER TERM CARE MINIMUM DATA SET
   LONG RANGE
   LOOP
   LOW COST ALTERNATIVE

M
   MALNUTRITION
   MAMMOGRAM
   MANAGED CARE
   MANAGED CARE ORGANIZATION
   MANAGED CARE PAYMENT SUSPENSION
   MANAGED CARE PLAN
   MANAGED CARE PLAN WITH A POINT OF SERVICE OPTION (POS)
   MANAGED CARE SYSTEM
   MANDATORY SPENDING
   MANDATORY SUPPLEMENTAL BENEFITS
   MANUAL CLAIM REVIEW
   MANUAL TRANSMITTALS
   MARKET BASKET
   MASS IMMUNIZATION CENTER
   MATERIAL WEAKNESS
   MAXIMUM DEFINED DATA SET
   MAXIMUM ENROLLEE OUT-OF-POCKET COSTS
   MAXIMUM PLAN BENEFIT COVERAGE
   MAXIMUM TAXABLE AMOUNT OF ANNUAL EARNINGS
   MAXIMUM TAX BASE
   MCO OR PHP STANDARDS
   MEASUREMENT
   MEDIATE
   MEDICAID-ONLY MCO
   MEDICAID
   MEDICAID MANAGEMENT INFORMATION SYSTEM
   MEDICAID MCO
   MEDICALLY NECESSARY
   MEDICAL BILLING
   MEDICAL BILLING AND CODING JOBS
   MEDICAL CODE SETS
   MEDICAL CODING
   MEDICAL INSURANCE (PART B)
   MEDICAL RECORDS INSTITUTE
   MEDICAL REVIEW OR UTILIZATION REVIEW
   MEDICAL UNDERWRITING
   MEDICARE-APPROVED AMOUNT
   MEDICARE
   MEDICARE ADVANTAGE PLAN
   MEDICARE BENEFITS
   MEDICARE BENEFITS NOTICE
   MEDICARE CARRIER
   MEDICARE CONTRACTOR
   MEDICARE COORDINATION OF BENEFITS CONTRACTOR
   MEDICARE COVERAGE
   MEDICARE COVERAGE ADVISORY COMMITTEE (MCAC)
   MEDICARE DURABLE MEDICAL EQUIPMENT REGIONAL CARRIER
   MEDICARE ECONOMIC INDEX
   MEDICARE HANDBOOK
   MEDICARE MANAGED CARE PLAN
   MEDICARE MEDICAL SAVINGS ACCOUNT PLAN (MSA)
   MEDICARE NATIONAL COVERAGE DETERMINATIONS MANUAL
   MEDICARE PART A (HOSPITAL INSURANCE)
   MEDICARE PART A FISCAL INTERMEDIARY
   MEDICARE PART B (MEDICAL INSURANCE)
   MEDICARE PART B CARRIER
   MEDICARE PART B PREMIUM REDUCTION AMOUNT
   MEDICARE PAYMENT ADVISORY COMMISSION
   MEDICARE+CHOICE
   MEDICARE+CHOICE PLAN
   MEDICARE PREFERRED PROVIDER ORGANIZATION (PPO) PLAN
   MEDICARE PREMIUM COLLECTION CENTER (MPCC)
   MEDICARE PRIVATE FEE-FOR-SERVICE PLAN
   MEDICARE REMITTANCE ADVICE REMARK CODES
   MEDICARE SAVINGS PROGRAM
   MEDICARE SAVINGS PROGRAMS
   MEDICARE SECONDARY PAYER
   MEDICARE SELECT
   MEDICARE SUMMARY NOTICE (MSN)
   MEDICARE SUPPLEMENT INSURANCE
   MEDICARE TRUST FUNDS
   MEDIGAP POLICY
   MEMORANDUM OF UNDERSTANDING
   MILITARY SERVICE WAGE CREDITS
   MILITARY TREATMENT FACILITY
   MINIMUM SCOPE OF DISCLOSURE
   MODALITY
   MODIFIED AVERAGE-COST METHOD
   MODIFY OR MODIFICATION
   MONITORING
   MONITORING OF MCO OR PHP STANDARDS
   MORBIDITY
   MORBIDITY RATE
   MORTALITY RATE
   MULTI-EMPLOYER GROUP HEALTH PLAN
   MULTI-EMPLOYER PLAN
   MULTIPLE EMPLOYER PLAN
   M+C ORGANIZATION (MEDICARE+CHOICE)
   M+C PLAN

N
   NATIONAL ASSOCIATION OF HEALTH DATA ORGANIZATIONS
   NATIONAL ASSOCIATION OF INSURANCE COMMISSIONERS
   NATIONAL ASSOCIATION OF STATE MEDICAID DIRECTORS
   NATIONAL CENTER FOR HEALTH STATISTICS
   NATIONAL COMMITTEE FOR QUALITY ASSURANCE
   NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA)
   NATIONAL COMMITTEE ON VITAL AND HEALTH STATISTICS
   NATIONAL COUNCIL FOR PRESCRIPTION DRUG PROGRAMS
   NATIONAL COVERAGE ANALYSES (NCA)
   NATIONAL COVERAGE DETERMINATIONS (NCDS)
   NATIONAL COVERAGE POLICY
   NATIONAL DRUG CODE
   NATIONAL EMPLOYER ID
   NATIONAL HEALTH INFORMATION INFRASTRUCTURE
   NATIONAL IMPROVEMENT PROJECTS
   NATIONAL MEDIAN CHARGE
   NATIONAL PATIENT ID
   NATIONAL PAYER ID
   NATIONAL PROVIDER FILE
   NATIONAL PROVIDER IDENTIFIER
   NATIONAL PROVIDER REGISTRY
   NATIONAL PROVIDER SYSTEM
   NATIONAL STANDARD FORMAT
   NATIONAL STANDARD PER VISIT RATES
   NATIONAL UNIFORM BILLING COMMITTEE
   NATIONAL UNIFORM CLAIM COMMITTEE
   NCPDP BATCH STANDARD
   NCPDP TELECOMMUNICATION STANDARD
   NEBULIZERS
   NEGLECT
   NETWORK
   NO-FAULT INSURANCE
   NON-COVERED SERVICE
   NON-ENTITY ASSETS
   NON-FEDERAL AGENCY
   NON-FORMULARY DRUGS
   NONCONTRIBUTORY OR DEEMED WAGE CREDITS
   NONPARTICIPATING PHYSICIAN
   NORTH CAROLINA HEALTHCARE INFORMATION AND COMMUNICATIONS ALLIANCE
   NOTICE OF INTENT
   NOTICE OF PROPOSED RULEMAKING
   NPLANID
   NUBC EDI TAG
   NURSE PRACTITIONER
   NURSING FACILITY
   NURSING HOME
   NUTRITION

O
   OBLIGATION
   OCCUPATIONAL THERAPY
   OFFICE
   OFFICE FOR CIVIL RIGHTS
   OFFICE OF MANAGEMENT & BUDGET
   OFFSET
   OLD-AGE, SURVIVORS, AND DISABILITY INSURANCE
   OMBUDSMAN
   ON-SITE REVIEWS
   OPEN ENROLLMENT PERIOD
   OPEN SYSTEM INTERCONNECTION
   OPTIONAL SUPPLEMENTAL BENEFITS
   ORGAN
   ORGANIZATIONAL DETERMINATION
   ORGAN PROCUREMENT
   ORGAN PROCUREMENT ORGANIZATION
   ORIGINAL MEDICARE PLAN
   OTHER MANAGED CARE ARRANGEMENT
   OTHER UNLISTED FACILITY
   OUT-OF-POCKET COSTS
   OUTCOME
   OUTCOME AND ASSESSMENT INFORMATION SET
   OUTCOME DATA
   OUTCOME INDICATOR
   OUTLAY
   OUTLIER
   OUTPATIENT CARE
   OUTPATIENT HOSPITAL
   OUTPATIENT HOSPITAL SERVICES (MEDICARE)
   OUTPATIENT PROSPECTIVE PAYMENT SYSTEM
   OUTPATIENT SERVICES
   OUT OF AREA
   OUT OF NETWORK BENEFIT
   OVERPAYMENT ASSESSMENT

P
   PANEL SIZE
   PAP TEST
   PARTIALLY CAPITATED
   PARTIAL CAPITATION
   PARTIAL HOSPITALIZATION
   PARTICIPATING HOSPITALS
   PARTICIPATING PHYSICIAN OR SUPPLIER
   PART A (HOSPITAL INSURANCE)
   PART A (MEDICARE)
   PART A OF MEDICARE
   PART A PREMIUM
   PART B (MEDICAL INSURANCE)
   PART B (MEDICARE)
   PART B OF MEDICARE
   PATIENT ADVOCATE
   PATIENT LIFTS
   PATTERN ANALYSIS
   PAY-AS-YOU-GO FINANCING
   PAYER
   PAYERID
   PAYMENT
   PAYMENT RATE
   PAYMENT SAFEGUARDS
   PAYMENT SUSPENSION
   PAYROLL TAXES
   PELVIC EXAM
   PERCENTILE
   PERFORMANCE
   PERFORMANCE ASSESSMENT
   PERFORMANCE IMPROVEMENT PROJECTS
   PERFORMANCE MEASURE
   PERFORMANCE MEASURES
   PERIODS OF CARE (HOSPICE)
   PERITONEAL DIALYSIS
   PERITONEAL DIALYSIS (PD)
   PERSONAL CARE
   PHYSICAL THERAPY
   PHYSICIAN ASSISTANT (PA)
   PHYSICIAN GROUP
   PHYSICIAN INCENTIVE PLAN
   PHYSICIAN SERVICES
   PLAN ID
   PLAN OF CARE
   PLAN SPONSOR
   POINT-OF-SERVICE (POS)
   POINT OF SERVICE (POS)
   POLICY ADVISORY GROUP
   POSTPAYMENT REVIEW
   POTENTIAL FRAUD CASE
   POTENTIAL PAYMENTS
   POWER OF ATTORNEY
   PRE-EXISTING CONDITION
   PREFERRED PROVIDER ORGANIZATION
   PREFERRED PROVIDER ORGANIZATION (PPO)
   PREFERRED PROVIDER ORGANIZATION (PPO) PLAN
   PREMIUM SURCHARGE
   PREPAID HEALTH PLAN
   PREPAYMENT REVIEW
   PRESENT VALUE
   PREVALENCE
   PREVENTIVE SERVICES
   PRICER
   PRICER OR REPRICER
   PRIMARY CARE
   PRIMARY CARE CASE MANAGEMENT PROVIDER
   PRIMARY CARE DOCTOR
   PRIMARY CASE MANAGEMENT
   PRIMARY PAYER
   PRIVACY ACT OF 1974
   PRIVATE CONTRACT
   PRIVATE FEE-FOR-SERVICE PLAN
   PROCEDURE
   PROCESS
   PROCESS IMPROVEMENT
   PROCESS INDICATOR
   PRODUCTIVITY INVESTMENTS
   PROFILES
   PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
   PROGRAM MANAGEMENT
   PROGRAM MANAGEMENT AND MEDICAL INFORMATION SYSTEM
   PROGRAM SAFEGUARD CONTRACTOR
   PROJECTION ERROR
   PROJECT OFFICER
   PROSPECTIVE PAYMENT SYSTEM
   PROS AND CONS
   PROTECTED HEALTH INFORMATION
   PROVIDER
   PROVIDER NETWORK
   PROVIDER SPONSORED ORGANIZATION (PSO)
   PROVIDER SURVEY DATA
   PROVIDER TAXONOMY CODES
   PROXY
   PSYCHIATRIC FACILITY (PARTIAL HOSPITALIZATION)
   PSYCHIATRIC RESIDENTIAL TREATMENT CENTER
   PUBLIC USE FILE
   PURCHASE ORDER

Q
   QUALIFIED MEDICARE BENEFICIARY (QMB)
   QUALIFYING INDIVIDUALS (1) (QI-1S)
   QUALIFYING INDIVIDUALS (2) (QI-2S)
   QUALITY
   QUALITY ASSURANCE
   QUALITY IMPROVEMENT ORGANIZATION
   QUINQUENNIAL MILITARY SERVICE DETERMINATION AND ADJUSTMENTS

R
   RAILROAD RETIREMENT
   RANDOM SAMPLE
   REAL-WAGE DIFFERENTIAL
   REASONABLE-COST BASIS
   REASONABLE COST
   RECIPIENT
   RECOUPMENT
   REFERRAL
   REFERRAL SERVICES
   REGENSTRIEF INSTITUTE
   REGIONAL HOME HEALTH INTERMEDIARY (RHHI)
   REGIONAL OFFICE
   REHABILITATION
   REHABILITATION (AS DISTINGUISHED FROM VOCATIONAL REHABILITATION)
   REJECT STATUS
   RENAL TRANSPLANT CENTER
   REOPENING
   REPORT CARD
   REQUESTOR
   RERELEASE
   RESEARCH DATA ASSISTANCE CENTER
   RESEARCH PROTOCOL
   RESERVE DAYS
   RESIDENTIAL SUBSTANCE ABUSE TREATMENT FACILITY
   RESIDUAL FACTORS
   RESOURCE-BASED RELATIVE VALUE SCALE
   RESPITE CARE
   RESTRAINTS
   REUSE
   REVENUE
   REVENUE CODE
   REVIEW OF CLAIMS
   RIGHTS OF INDIVIDUALS
   RISK-BASED HEALTH MAINTENANCE ORGANIZATION OR COMPETITIVE MEDICAL PLAN
   RISK ADJUSTMENT
   ROUTINE USE
   RURAL HEALTH CLINIC

S
   SANCTIONS
   SECONDARY PAYER
   SECOND OPINION
   SECRETARY
   SEER - MEDICARE DATABASE
   SEER PROGRAM
   SEGMENT
   SELF-EMPLOYMENT
   SELF-EMPLOYMENT CONTRIBUTION ACT PAYROLL TAX
   SELF-INSURED
   SELF DIALYSIS
   SEQUESTER
   SERVICE
   SERVICE AREA
   SERVICE AREA (PRIVATE FEE-FOR-SERVICE)
   SERVICE CATEGORY DEFINITION
   SHORT RANGE
   SIDE EFFECT
   SINGLE DRUG PRICER
   SKILLED CARE
   SKILLED NURSING CARE
   SKILLED NURSING FACILITY
   SKILLED NURSING FACILITY (SNF)
   SKILLED NURSING FACILITY CARE
   SMALL HEALTH PLAN
   SMI PREMIUM
   SNF COINSURANCE
   SOCIAL HEALTH MAINTENANCE ORGANIZATION (SHMO)
   SOCIAL SECURITY ACT
   SOCIAL SECURITY ADMINISTRATION
   SPECIALIST
   SPECIALTY CONTRACTOR
   SPECIALTY PLAN
   SPECIAL ELECTION PERIOD
   SPECIAL ENROLLMENT PERIOD
   SPECIAL PUBLIC-DEBT OBLIGATION
   SPECIFIED DISEASE INSURANCE
   SPECIFIED LOW-INCOME MEDICARE BENEFICIARIES (SLMB)
   SPEECH-LANGUAGE THERAPY
   SPELL OF ILLNESS
   STAFF ASSISTED DIALYSIS
   STANDARD CLAIMS PROCESSING SYSTEM
   STANDARD TRANSACTION
   STATE CERTIFICATION
   STATE CHILDRENS HEALTH INSURANCE PROGRAM
   STATE HEALTH INSURANCE ASSISTANCE PROGRAM
   STATE INSURANCE DEPARTMENT
   STATE LAW
   STATE LICENSURE AGENCY
   STATE MEDICAL ASSISTANCE OFFICE
   STATE OR LOCAL PUBLIC HEALTH CLINIC
   STATE SURVEY
   STATE SURVEY AGENCY
   STATE UNIFORM BILLING COMMITTEE
   STATUS LOCATION
   STOCHASTIC MODEL
   STRATEGIC NATIONAL IMPLEMENTATION PROCESS
   SUBSIDIZED SENIOR HOUSING
   SUBSTANTIAL FINANCIAL RISK
   SUMMARIZED COST RATE
   SUMMARIZED INCOME RATE
   SUPPLEMENTAL EDIT SOFTWARE
   SUPPLEMENTARY MEDICAL INSURANCE
   SUPPLIER
   SURVEY AND CERTIFICATION PROCESS
   SUSPENSION OF PAYMENTS
   SUSTAINABLE GROWTH RATE
   SYNTAX
   SYSTEMATIC
   SYSTEM NOTICE
   SYSTEM OF RECORDS

T
   TAXABLE EARNINGS
   TAXABLE PAYROLL
   TAXABLE SELF-EMPLOYMENT INCOME
   TAXABLE WAGES
   TAXATION OF BENEFITS
   TAXES
   TAX AND DONATIONS
   TAX RATE
   TECHNOLOGY ASSESSMENT (TA)
   TELEMEDICINE
   TERM INSURANCE
   TEST OF LONG-RANGE CLOSE ACTUARIAL BALANCE
   TEST OF SHORT-RANGE FINANCIAL ADEQUACY
   THIRD PARTY ADMINISTRATOR
   THIRD PARTY USE
   TIER
   TRADING PARTNER
   TRANSACTION
   TRANSACTION CHANGE REQUEST SYSTEM
   TRANSIENT PATIENTS
   TRANSPLANT
   TRAUMA CODE DEVELOPMENT
   TREATMENT
   TREATMENT OPTIONS
   TRICARE
   TRICARE FOR LIFE (TFL)
   TRUE NEGATIVES
   TRUST FUND
   TRUST FUND RATIO
   TTY

U
   UB-82
   UB-92
   UNASSIGNED CLAIM
   UNIFORM CLAIM TASK FORCE
   UNITED NATIONS CENTRE FOR FACILITATION OF PROCEDURES AND PRACTICES FOR ADMINISTRATION, COMMERCE, AND
   UNITED NATIONS RULES FOR ELECTRONIC DATA INTERCHANGE FOR ADMINISTRATION, COMMERCE, AND TRANSPORT
   UNIT INPUT INTENSITY ALLOWANCE
   URGENTLY NEEDED CARE
   UTAH HEALTH INFORMATION NETWORK
   UTILIZATION SUMMARY DATA

V
   VALIDATION
   VALUATION PERIOD
   VALUE-ADDED NETWORK
   VIRTUAL PRIVATE NETWORK
   VOCATIONAL REHABILITATION
   VOLUNTARY AGREEMENT
   VOLUNTARY ENROLLEE

W
   WAITING PERIOD
   WASHINGTON PUBLISHING COMPANY
   WITHHOLD
   WORKERS COMPENSATION
   WORKFORCE
   WORKGROUP FOR ELECTRONIC DATA INTERCHANGE
   WORLD HEALTH ORGANIZATION

X
   X12
   X12F
   X12J
   X12N
   X12N OR SPTG4
   X12N OR TG1
   X12N OR TG2
   X12N OR TG2 OR WG1
   X12N OR TG2 OR WG12
   X12N OR TG2 OR WG15
   X12N OR TG2 OR WG19
   X12N OR TG2 OR WG2
   X12N OR TG2 OR WG3
   X12N OR TG2 OR WG4
   X12N OR TG2 OR WG5
   X12N OR TG2 OR WG9
   X12N OR TG3
   X12N OR TG3 OR WG1
   X12N OR TG3 OR WG21
   X12N OR TG3 OR WG3
   X12N OR TG3 OR WG4
   X12N OR TG4
   X12N OR TG8
   X12N TG2 WG10
   X12 148
   X12 270
   X12 271
   X12 274
   X12 275
   X12 276
   X12 277
   X12 278
   X12 811
   X12 820
   X12 831
   X12 834
   X12 835
   X12 837
   X12 997
   X12 IHCEBI & IHCEBR
   X12 IHCLME
   X12 OR PRB
   X12 STANDARD

Y
   YEAR OF EXHAUSTION