Acronyms

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Acronym	Term	Description
ANSI	American National Standards Institute
ASCA	Administrative Simplification Compliance Act
CCN	Claim Control Number	Number assigned to claims accepted by CEDI to be used to track claims processed by the DME MACs. Also referred to as ICN. Example: 09057850011000
CCP	CEDI Claims Portal	The CEDI Claims Portal (CCP ) provides a web based claim entry option for Medicare Durable Medical Equipment (DME ) suppliers with small claim volumes.
CEDI	Common Electronic Data Interchange	Electronic gateway for the exchange of Medicare DME transactions
CMN	Certificate of Medical Necessity	A certificate that supports the need of a DME item
CSI	Claim Status Inquiry	Allows suppliers to access claim status and beneficiary eligibility data. Supported by the individual DME MACs.
CWF	Common Working File	A record containing a beneficiary’s complete entitlement, utilization, history, Medicare Secondary Payer (MSP), and Health Maintenance Organization (HMO) data.
DME	Durable Medical Equipment	Medical equipment used at the patient’s place of residence that contributes to a better quality of life and can be used over an extended period of time.
DME MAC	Durable Medical Equipment Medicare Administrative Contractor
DMEPOS	Durable Medical Equipment, Prosthetics, Orthotics, and Supplies
EDI	Electronic Data Interchange
EFT	Electronic Funds Transfer	Direct deposit of Medicare payments to the supplier’s bank account. Supported by the individual DME MACs.
EMC	Electronic Media Claims
EOB	Explanation of Benefits	Detail description of benefits paid for a claim provided to the beneficiary
ERA	Electronic Remittance Advice	A detailed electronic report of payments/non-payments made by Medicare provided to the supplier. Also was referred to as an Electronic Remittance Notice (ERN)
HCPCS	Healthcare Common Procedure Coding System	A code used to identify products, supplies, and services. Also referred to as a procedure code
HETS	HIPAA Eligibility Transaction System	HIPAA Eligibility Transaction System (HETS) allows users to exchange HIPAA compliant ANSI ASC X12 270/271 transactions for the purpose of checking Medicare eligibility.
HIPAA	Health Insurance Portability & Accountability Act	Requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers
ICN	Internal Control Number	Requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers
MAC	Medicare Administrative Contractor
NCPDP	National Council for Prescription Drug Programs	A format used by retail pharmacies that transmit DME retail drug claims electronically.
NDC	National Drug Code	The NDC replaces the HCPCS codes for retail pharmacy drug transactions billed to DME MACs via the NCPDP standard.
NPEAST	National Provider Enrollment Eastern Region	Entity who assigns unique numbers for suppliers in the Eastern Region that identifies the applicant as a DMEPOS supplier. The unique number is referred to as a PTAN or supplier number.
NPI	National Provider Identifier	Unique identifier assigned by the NPPES to health care providers. Example: 1234567891

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