AC Affiliated Contractor

AMA American Medical Association

BBA Balanced Budget Act of 1997

BETOS Berenson-Eggers Type of Service

CAFM Contractor Administrative-Budget and Financial Management System

CDAC Clinical Data Abstraction Center

CERT Comprehensive Error Rate Testing

CMN Certificate of Medical Necessity

CMS Centers for Medicare & Medicaid Services

CPT Current Procedural Terminology

CTRDS CERT Tracking and Reporting Database and System

CY Calendar Year

DARN Dollars at Risk of No Documentation

DHHS Department of Health and Human Services

DRG Diagnosis Related Group

DME Durable Medical Equipment

DMERC Durable Medical Equipment Regional Carrier

E&M Evaluation and Management

EMR Electronic Medial Records

ESRD End Stage Renal Disease

FFS Fee-for-Service

FI Fiscal Intermediary

FY Fiscal Year

GPRA Government Performance & Results Act of 1993

HCPCS Healthcare Common Procedure Coding System

HHA Home Health Agency

HICN Health Insurance Claim Number

HIPAA Health Insurance Portability and Accountability Act of 1996

HI Hospital Insurance

HPMP Hospital Payment Monitoring Program

ICD-9-CM International Classification of Diseases (10th Revision) Clinical Modification

IPIA Improper Payment Information Act

LCD Local Coverage Determination

LI Line Item

MAC Medicare Administrative Contractor

MMA Medicare Modernization Act

MFS Medicare Fee Schedule

MIP Medicare Integrity Program

MSP Medicare Secondary Payer

NCH National Claims History

OIG Office of the Inspector General

OPPS Outpatient Prospective Payment System

POE Provider Outreach and Education

PPS Prospective Payment System

PSC Program Safeguard Contractor

QIO Quality Improvement Organization

RAC Recovery Audit Contractors

RAP Request for Anticipated Payment

RHC Rural Health Clinic

RHHI Regional Home Health Intermediary

RTP Return to Provider

SNF Skilled Nursing Facility

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