A/R

Accounts Receivable

AAP

American Academy of Pediatrics

ACA

Affordable Care Act of 2010

ACD

Augmentative Communication Device

ACIP

Advisory Committee on Immunization Practices

ACSW

Academy of Certified Social Workers

AFP

Abdominal Flat Plates

AIDS

Acquired Immunodeficiency Syndrome

AIS

Automated Inquiry System

ALL

Acute Lymphoblastic Leukemia

AMA

American Medical Association

ANSI

American National Standards Institute

APN

Advanced Practice Nurse (former name for APRN)

APRN

Advanced Practice Registered Nurse

ASA

American Society of Anesthesiologists

ASBMT

American Society for Blood and Marrow Transplantation

ASC

Ambulatory Surgical Center

ATP

Assistive Technology Professional

AWP

Average Wholesale Price

BCBS

Blue Cross Blue Shield

BCG

Bacille Calmette-Guérin

BiPAP

Bi-level Positive Airway Pressure

BON

(Texas) Board of Nursing

BSSW

Bachelor of Science in Social Work

CAPD

Continuous Ambulatory Peritoneal Dialysis

CBC

Complete Blood Count

C/C

Cleft/Craniofacial

CCP

Comprehensive Care Program

CCPD

Continuous Cycling Peritoneal Dialysis

CDT

Current Dental Terminology

CHIP

Children’s Health Insurance Program

CLIA

Clinical Laboratory Improvement Amendments

CML

Chronic Myelogenous Leukemia

CMS

Centers for Medicare & Medicaid Services (formerly HCFA)

CNS

Clinical Nurse Specialist

CPAP

Continuous Positive Airway Pressure

CPR

Cardiopulmonary Resuscitation

CPT

Current Procedural Terminology

CRCP

Certified Respiratory Care Practitioner

CRNA

Certified Registered Nurse Anesthetist

CSHCN

Children with Special Health Care Needs

CSI

Claim Status Inquiry

CT

Computed Tomography

CVA

Cerebrovascular Accident

DDS

Doctor of Dental Surgery

DEFRA

Deficit Reduction Act of 1984

DMD

Doctor of Dental Medicine

DME

Durable Medical Equipment

DO

Doctor of Osteopathy

DOB

Date of Birth

DOS

Date of Service

DPM

Doctor of Podiatric Medicine

DRG

Diagnosis-Related Group

DSHS

Department of State Health Services

DSM-IV-TR

Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision

E/M

Evaluation and Management (Services)

ECG

Electrocardiogram

EDI

Electronic Data Interchange

EEG

Electroencephalogram

EFT

Electronic Funds Transfer

EMG

Electromyography

EMTALA

Emergency Medical Treatment and Labor Act

EOB

Explanation of Benefits

EOG

Electro-oculogram

EOPS

Explanation of Pending Status

EPO

Erythropoietin Alfa

EPSDT

Early Periodic Screening, Diagnosis, and Treatment

ER&S

Electronic Remittance and Status report

ESWL

Extracorporeal Shock Wave Lithotripsy

EV

Eligibility Verification

fMRI

Functional Magnetic Resonance Imaging

FNP

Family Nurse Practitioner

FQHC

Federally Qualified Health Center

FSS

Family Support Services

FYE

Fiscal Year End

HASC

Hospital-based Ambulatory Surgical Center

HBOT

Hyperbaric Oxygen Therapy

HCPCS

Healthcare Common Procedure Coding System

HCSSA

Home and Community Services Support Agency

HFCWCS

High Frequency Chest Wall Compression Systems

HHA

Home Health Agency

HHS

Health and Human Services

HHSC

Health and Human Services Commission

HIPAA

Health Insurance Portability and Accountability Act

HIV

Human Immunodeficiency Virus

HKAFO

Hip-Knee-Ankle-Foot Orthotics

HLA

Human Leukocyte Antigen

HMO

Health Maintenance Organization

HO

Hip Orthotics

ICD-9-CM

International Classification of Diseases, Ninth Revision, Clinical Modification

ICD-10-CM

International Classification of Diseases, Tenth Revision, Clinical Modification

ICD-10-PCS

International Classification of Diseases, Tenth Revision, Procedure Coding System

ICF

Intermediate Care Facility (refer to also SNF)

ICF/IID

Intermediate Care Facility for Individuals with Intellectual Disabilities

ICN

Internal Control Number (as in, 24-digit ICN) assigned to a specific claim

ID

Intradermal

IM

Intramuscular

iMRI

Intraoperative Magnetic Resonance Imaging

IOL

Intraocular Lens

IPD

Intermittent Peritoneal Dialysis

IPPA

Insurance Premium Payment Assistance

IPPB

Intermittent Positive Pressure Breathing

IPV

Intrapulmonary Percussive Ventilation

IRS

Internal Revenue Service

IV

Intravenous

JRA

Juvenile Rheumatoid Arthritis

KAFO

Knee-Ankle-Foot Orthotics

KO

Knee Orthotics

KUB

Kidneys, Ureters, and Bladder

LBSW

Licensed Baccalaureate Social Worker

LCSW

Licensed Clinical Social Worker

LDL

Low Density Lipoprotein

LMFT

Licensed Marriage and Family Therapist

LMSW

Licensed Master Social Worker

LMSW-AP

Licensed Master Social Worker-Advanced Practitioner

LPC

Licensed Professional Counselor

LVN

Licensed Vocational Nurse

MD

Doctor of Medicine

MMIS

Medicaid Management Information System

MNC

Medically Needy Clearinghouse

MNP

Medically Needy Program

MPH

Master of Public Health

MRA

Magnetic Resonance Angiography

MRI

Magnetic Resonance Imaging

MSRP

Manufacturers Suggested Retail Price

MSSW

Master of Science in Social Work

MSUD

Maple Syrup Urine Disease (also called branched-chain ketoaciduria)

MSW

Master of Social Work

MTP

Medical Transportation Program

NCCI

National Correct Coding Initiative

NDC

National Drug Code

NOS

Not Otherwise Specified

NP

Nurse Practitioner

NPI

National Provider Identifier

OI

Other Insurance

OMT

Osteopathic Manipulation Treatment

OT

Occupational Therapy, Occupational Therapist

PACT

Program for Amplification for Children of Texas (Hearing Aids/Services)

PAF

Physician/Dentist Assessment Form

PAN

Prior Authorization Number

PCN

Patient Control Number

PDA

Personal Digital Assistant

PDF

Portable Document Format

PET

Positron Emission Tomography (PET scan)

PKU

Phenylketonuria

PNP

Pediatric Nurse Practitioner

POC

Plan of Care

POS

Place of Service

PPMP

Physician-Performed Microscopy Procedures

PPO

Preferred Provider Organization

PT

Physical Therapy, Physical Therapist

RAST

Radioallergosorbent Test

RBRVS

Resource-Based Relative Value Scale

RESNA

Rehabilitation Engineering and Assistive Technology Society of North America

RGO

Reciprocating Gait Orthosis

RHC

Rural Health Clinic

RN

Registered Nurse

RSV

Respiratory Syncytial Virus

RVU

Relative Value Unit

SC

Subcutaneous

SID

Surface Identification

SLP

Speech-Language Pathology/Speech-Language Pathologist

SNF

Skilled Nursing Facility (refer to also ICF)

SO

Spinal Orthotics

SSL

Secure Socket Layer

TAC

Texas Administrative Code

TANF

Temporary Assistance to Needy Families (formerly AFDC)

TEFRA

Tax Equity and Fiscal Responsibility Act of 1982

TENS

Transcutaneous Electric Nerve Stimulator

THKAO

Thoracic-Hip-Knee-Ankle Orthotics

THSteps

Texas Health Steps (Texas name for EPSDT)

THSteps-CCP

Texas Health Steps Comprehensive Care Program (Texas name for EPSDT-CCP) (now called CCP)

TMHP

Texas Medicaid & Healthcare Partnership

TMRM

Texas Medicaid Reimbursement Methodology

TOB

Type of Bill

TOS

Type of Service

TPN

Total Parenteral Nutrition (i.e., Hyperalimentation)

TPR

Third-Party Resource

TSBDE

Texas State Board of Dental Examiners

TVFC

Texas Vaccines for Children

UB-04

Uniform Bill 04 CMS-1450

UCB

University of California at Berkeley

VDP

Vendor Drug Program

VIPS

Voice Inquiry Processing System

VPN

Virtual Private Networking