A/R

Accounts Receivable

AA

Anesthesiologist Assistant

AAP

American Academy of Pediatrics

AASM

American Academy of Sleep Medicine

ABPM

Ambulatory Blood Pressure Monitoring

ACA

Affordable Care Act of 2010

ACD

Augmentative Communication Device

ACIP

Advisory Committee on Immunization Practices

ACSW

Academy of Certified Social Workers

ADA

American Dental Association

AFP

Abdominal Flat Plates

AFT

Autonomic Function Test

AIDS

Acquired Immunodeficiency Syndrome

AIS

Automated Inquiry System

ALL

Acute Lymphoblastic Leukemia

AMA

American Medical Association

ANSI

American National Standards Institute

APR-DRG

All Patient Refined Diagnosis Related Groups

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

C/C

Cleft/Craniofacial

CAD

Clinician-Administered Drug

CAPD

Continuous Ambulatory Peritoneal Dialysis

CBC

Complete Blood Count

CBT

Computer-based Training

CCP

Comprehensive Care Program

CCPD

Continuous Cycling Peritoneal Dialysis

CDT

Current Dental Terminology

CGM

Continuous Glucose Monitors

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

CompSA

Complex Sleep Apnea

COPD

Chronic Obstructive Pulmonary Disease

CPAP

Continuous Positive Airway Pressure

CPR

Cardiopulmonary Resuscitation

CPT

Current Procedural Terminology

CRCP

Certified Respiratory Care Practitioner

CRNA

Certified Registered Nurse Anesthetist

CSA

Central Sleep Apnea

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

DPC

Diagnostic Procedure Code

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

EMS

Emergency Medical Services

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

FDA

Food and Drug Administration

FES

Functional Electrical Stimulation

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

HHA

Home Health Aide

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

[Revised] Hip Orthosis

ICD-10-CM

International Classification of Diseases, Tenth Revision, Clinical Modification

ICD-10-PCS

International Classification of Diseases, Tenth Revision, Procedure Coding System

ICD-9-CM

International Classification of Diseases, Ninth Revision, Clinical Modification

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

Identification

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

KO

Knee Orthosis

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

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

MSW

Master of Social Work

MTP

Medical Transportation Program

MUE

Medically Unlikely Edits

NCCI

National Correct Coding Initiative

NDC

National Drug Code

NIC

National Interpreter Certificate

NP

Nurse Practitioner

NPI

National Provider Identifier

OFL

Online Fee Lookup

OI

Other Insurance

OMT

Osteopathic Manipulation Treatment

OP

Outpatient

OPL

Online Provider Lookup

OSA

Obstructive Sleep Apnea

OT

Occupational Therapy, Occupational Therapist

PA

Physician Assistant

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

PEMS

Provider Enrollment and Management System

PENS

Percutaneous Electrical Nerve Stimulation

PET

Positron Emission Tomography (PET scan)

PHQ-9

Patient Health Questionnaire

PKU

Phenylketonuria

PLP

Provisionally Licensed Psychologist

PNP

Pediatric Nurse Practitioner

POA

Present on Admission

POC

Plan of Care

POS

Place of Service

PPECC

Prescribed Pediatric Extended Care Centers

PPMP

Physician-Performed Microscopy Procedures

PPO

Preferred Provider Organization

PT

Physical Therapy, Physical Therapist

R&S

Remittance and Status

RAD

Respiratory Assist Device

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

RID

National Registry of Interpreters for the Deaf

RN

Registered Nurse

RSV

Respiratory Syncytial Virus

RT

Right Side

RVU

Relative Value Unit

SBGM

Self Blood Glucose Monitoring

SBRT

Stereotactic Body Radiation Therapy

SC

Subcutaneous

SID

Surface Identification

SLP

Speech-Language Pathology/Speech-Language Pathologist

SMBPM

Self-Measured Blood Pressure Monitoring

SNF

Skilled Nursing Facility (refer to also ICF)

SNS

Sacral Nerve Stimulation

SOC

Start of Care

SRS

Stereotactic Radiosurgery Services

SSL

Secure Socket Layer

ST

Speech Therapy

SVN

Small Volume Nebulizer

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 Stimulation

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)

TID

Tooth Identification

TIP

Treatment in Place

TLSO

Thoracic-lumbar-sacral Orthoses

TMHP

Texas Medicaid & Healthcare Partnership

TMRM

Texas Medicaid Reimbursement Methodology

TOB

Type of Bill

TOS

Type of Service

TPL

Third-party Liability

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

UNOS

United Network for Organ Sharing

VDP

Vendor Drug Program

VIPS

Voice Inquiry Processing System

VPN

Virtual Private Networking