Acronyms Search

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
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
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.
NPI National Provider Identifier Unique identifier assigned by the NPPES to health care providers. Example: 1234567891
NPPES National Plan & Provider Enumeration System Entity who assigns unique identifiers for health care providers and health plans as mandated by HIPAA (NPI)
NSC National Supplier Clearinghouse Entity who assigns unique numbers that identifies the applicant as a DMEPOS supplier. The unique number is referred to as a PTAN, supplier, or NSC number.
NSV Network Service Vendor Entity who offers connectivity over a dedicated line to a Medicare contractor including CEDI
PECOS Provider Enrollment , Chain and Ownership System PECOS is the Internet-based Medicare enrollment system. For more information visit http://www.cms.gov
PTAN Provider Transaction Access Number Unique supplier number assigned by the NSC. This number is 10 digits and typically ends in a 0001, 0002, 0003, or something similar.
TP Trading Partner Submitter who exchanges electronic transactions with CEDI. Also referred to as a submitter or sender.
TP ID Trading Partner Identifier Unique identifier used by the Trading Partner (Submitter/Sender) assigned by CEDI. Example: B08123456 This will begin with A08, B08, C08, or D08 followed by 6 digits.