Encounter Data Acronyms

A

ACA - Affordable Care Act

ANSI - American National Standards Institute

ASCA - Administrative Simplification Compliance Act

C

CAS -Claims Level Adjustment Segment

CEM - Common Edits and Enhancement Module

CMP - Competitive Medical Plan

COTS - Commercial Off-the-Shelf

CPT - Current Procedural Terminology

D

DME - Durable Medical Equipment

DMEPOS - Durable Medical Equipment Prosthetics, Orthotics, and Supplies

E

EDCWF - Encounter Data Common Working File

EDDPPS - Encounter Data DME Processing and Pricing Sub-System

EDFES - Encounter Data Front-End System

EDFESC - Encounter Data Front-End System Contractor

EDI - Electronic Data Interchange

EDIPPS - Encounter Data Institutional Processing and Pricing Sub-System

EDPPPS - Encounter Data Professional Processing and Pricing Sub-System

EDPS - Encounter Data Processing System

EDPSC - Encounter Data Processing System Contractor

EDS - Encounter Data System

EODS - Encounter Operational Data Store

F

FFS - Fee-For-Service

FISS - Fiscal Intermediary Standard System

FS - Fee Schedule

FTP - File Transfer Protocol

H

HCPC - HCFA Common Procedure Code

HCPCS - Healthcare Common Procedure Coding System

HCPP - Health Care PrePayment Plan

HIPAA - Health Insurance Portability & Accountability Act of 1996

HIPPS - Health Insurance Prospective Payment System

HMO - Health Maintenance Organization

I

IG Edits - Implementation Guide Edits

I/OCE - Integrated/Outpatient Code Editor

M

MA - Medicare Advantage

MAO - Medicare Advantage Organization

MCE - Medicare Code Editor

MCS - Multi-Carrier System

MUE - Medically Unlikely Edits

N

NCCI - National Correct Coding Initiative

NPI - National Provider Identifier

NPPES - National Plan and Provider Enumeration System

NUCC - National Uniform Claim Committee

O

OASIS - Outcome and Assessment Information Set

P

PACE - Program for All-Inclusive Care for the Elderly

PDE - Prescription Drug Event

POS - Place of Service

PPACA - Patient Protection and Affordable Care Act

PPS - Prospective Payment System

R

RAPS - Risk Adjustment Processing System

S

SNF - Skilled Nursing Facility

T

TOB - Type of Bill

TOS - Type of Service

V

VMS - ViPS Medicare System

W

WPC - Washington Publishing Company