AABB		American Association of Blood Banks.
AAOS		American Academy of Orthopaedic Surgeons.
AAPA		American Academy of Physician Assistants.
AAPCC		Adjusted Average Per Capita Cost. The amount o funding a managed care plan receives from HCFA to cover costs. The formula, calculated by region, allows for 95% of fee-for-service rates.
AAPPO		American Association of Preferred Provider Organizations.
AAPS		American Association of Pharmaceutical Scientists.
ABC Analysis		Also called ABC Classification, is a general inventory analysis method. It classifies items in decreasing order of annual dollar volume. Class A contains the items with the highest annual dollar volume and receives the most attention. The ABC method is based on the 80/20 rule that says a small percentage of a group accounts for the largest fraction of effort or value. Groups Quantity (% of items) Value (% of $) Degree of Control Types of Records Safety Stock Ordering Procedures A Items 10-20% 70-80% Tight Complete, accurate Low Careful, accurate; frequent reviews B Items 30-40% 15-20% Normal Complete, accurate Moderate Normal ordering; some expediting C Items 40-50% 5-10% Simple Simplified Large Order periodically; 1- to 2-year supply This analysis, for example, can be applied to pharmaceuticals to manage drug costs. It is used to ascertain the volume of products by expense (i.e., dollars) and by utilization (i.e., units) to review product use on a regular basis.
ABN Form		Advance Beneficiary Notice. Medicare patients who do not meet the Medicare definition of medical necessity must review and sign the ABN form. HCFA requires physicians to educate patients about what services Medicare does not cover. If it is not clear whether Medicare will cover a specific service, the patient should sign an ABN form. The form states that the patient understands that Medicare may not cover the service and that he or she will pay for the service if Medicare does not. HCFA does not generally allow physicians to bill patients for uncovered services unless an ABN form has been signed by the patient.
ABR		Auditory Brain Stem Response. The ABR is a special hearing test that can be used to track the nerve signals arising in the inner ear as they travel through the hearing nerve (called the auditory nerve) to the region of the brain responsible for hearing. The test is useful because it can tell us where along that path the hearing loss has occurred. For example, the ABR is often used for individuals with a sensorineural (nerve) loss in just one ear. This loss can sometimes be caused by a benign (non-cancerous) tumor on the auditory nerve. If the ABR is normal along that region of the path, the chances of having this tumor are quite small. The ABR can also be used on small infants since it requires no conscious response from the person being tested. A small speaker is placed near the ear which produces clicking sound. Special electrodes automatically record the nerve signal; the patient can even be asleep during the test. [Source: Department of Otolaryngology-Head and Neck Surgery at the University of Washington School of Medicine]
ACCME		Accreditation Council for Continuing Medical Education.
ACCP		American College of Clinical Pharmacy.
ACEP		American College of Emergency Physicians, not to be confused with the ACOEP.
ACNM		American College of Nurse-Midwives.
ACOEP		American College of Osteopathic Emergency Physicians, not to be confused with the ACEP.
ACP-ASIM		American College of Physicians-American Society of Internal Medicine.
ACR-NEMA		American College of Radiology and National Electrical Manufacturers Association. These groups publish specifications for Digital Imaging and Communications in Medicine (DICOM). NEMA also publishes specifications for medical devices.
Actual Wholesale Price		Actual Wholesale Price of a prescription drug, for a given distributor (e.g., McKessonHBOC, Cardinal). Other sources of drug prices are: Average Wholesale Price, MAC Price, Wholesale Acquisition Price.
Acute Care		Treatment for a serious illness, an accident, or after surgery. It is usually given in a hospital by trained persons. It may also involve intensive care.
ADA		1. American Dietetic Association 2. American Dental Association
ADE		Adverse Drug Event. See ADR.
Administrative Services Only		See ASO.
Admission		The process of accepting a person as a patient in a hospital or other inpatient facility. This usually includes collecting the person’s demographic information, insurance information, medical condition, referring physician, etc.
Admitting Privileges		The right granted to a physician by a hospital or other type of inpatient facility to admit patients into that facility.
ADR		Adverse Drug Reaction. See ADE.
ADT		An abbreviation for Admission, Discharge and Transfer. Usually refers to the department, function, or software application responsible for tracking patients in, around and out of an healthcare institution.
Advance Directive		It is a written, legal document where you state your desires for health care should you become incapacitated. In California, there are two types of Advance Directives: a Declaration Pursuant to The Natural Death Act of California (formally referred to as “A Living Will”) and a Durable Power of Attorney for Health Care (DPAHC). The DPAHC allows you to state your desires about your healthcare in any situation in which you are unable to make your own decisions, not just when you are in a coma or terminally ill. It also allows you to choose another person, called your “agent” to carry out your stated wishes or to make decisions for you if you cannot speak for yourself.
AFEHCT		The Association for Electronic Healthcare Transactions.
Agency for Health Care Policy and Research		The Agency for Health Care Policy and Research(AHCPR), a part of the U.S. Department of Health and Human Services, is charged with supporting research to improve the quality of healthcare, reduce its cost, and broaden access to essential services. AHCPR's broad programs of research bring practical, science-based information to medical practitioners and patients.
Agent		1. A unique combination of active ingredients used in the formulation of a pharmaceutical. The drug ingredient names are either those adopted by USAN, or their chemical name. For multi-ingredient products, standard abbreviations are often used. Every product has a specific intended therapeutic usage. Thus, the sequence of generic names in multi-ingredient products is determined by therapeutic priority. The most pharmacologically active ingredient for the intended use will be listed first, followed in descending order of therapeutic significance by the other ingredients. 2. Also, an agent is the representative of an insurance company to be contacted when handling accident claims.
Aggregate Data		Personal information or non-personal individual information collected from a group of users that has been processed so that it can no longer be used to identify a single, unique individual. [Source: Hi-Ethics Coalition]
AHA		1. The American Heart Association. 2. The American Hospital Association.AGGREGATE DATA means personal information or non-personal individual information collected from a group of users that has been processed so that it can no longer be used to identify a single, unique individual.
AHCA		The American Health Care Association.
AHCPR		See Agency for Health Care Policy and Research.
AHERF		Allegheny Health, Education and Research Foundation, defunct since 1998.
AHFS		American Hospital Formulary Service. A group that publishes a big book with drug information in it (its publication is not paid for by drug companies). It categorizes drugs by NDC, the industry standard product coding scheme for pharmaceuticals. The resulting hierarchy is made up of three levels: categories, classes, and subclasses. The 6-digit AHFS classification code is displayed as CA:CL.SC where, CA is the 2-digit category identifier associated with the super category CA:00.00. CL is the 2-digit class identifier associated with the category CA:CL.00. Note that if CL is 00, then this is an AHFS category. SC is the 2-digit subclass identifier associated with the specific subclass identified as CA:CL.SC. Note that if SC is 00, then this is an AHFS class. For example, 04:00.00 Antihistamine Drugs CATEGORY 08:00.00 Anti-Infective Agents CATEGORY 08:12.00 Antibiotics CLASS 08:12.04 Antifungal Antibiotics SUBCLASS
AHIMA		The American Health Information Management Association.
AIDS		Anti-Immune Deficiency Syndrome.
AIIM		The Association for Information and Image Management is an international organization made up of people in the information management community.
ALOS		Average Length Of Stay (see LOS).
AMA		1. American Medical Association, the US physician’s union (since 1847). 2. AMA is also used in charts as an abbreviation for “Against Medical Advice,” as in “patient discharged himself from the ER AMA” (translation: “the patient sneaked out”).
Ambulatory		Outpatient care facilities, and procedures.
Ambulatory Patient Groups		See APG.
AMD		Age-related macular degeneration. A cause of blindness.
AMI		Acute Myocardial Infarction (i.e., bad news).
AMIA		American Medical Informatics Association
Ancillary Services		Tests, procedures, imaging and support healthcare services.
ANSOS		The industry’s leading commercial nurse scheduling system. This is a product of “the company formerly known as Atwork,” now a part of Medaphis.
ANSI		American National Institue of Standards.
AONE		The American Organization of Nurse Executives.
AORN		The Association of Operating Room Nurses.
APC		Ambulatory Patient Classifications. This coding hierarchy gathers ambulatory procedural and service codes from HCFA’s Producedural Coding System into 346 groups. These service bundles are the basis for Medicare reimbursement for both physician and hospital services under the prospective payment model. APCs are an outgrowth of APGs but CPT and management codes form part of the basis for it. The OPPS is described as a HCFA's proposed rule in the September 9, 1998 Federal Register (FR 63 47552).
APG		A visit-based outpatient classification system, Ambulatory Patient Groups are the basis for HCFA’s Outpatient Prospective Payment Syste. The original system was developed by 3M in 1989. Version 2.0 of the system includes 290 APGs which are divided into three categories: significant procedure and therapy groupings, medical visit groupings, and ancillary tests and procedures groupings. These groupings are defined in terms of specific CPT and ICD9-CM codes. APG reimbursement covers only the facility cost for rendering outpatient services and not the professional or physician component. Medicare will reimburse outpatient facilities a fixed rate determined in advance for facility expenses; it does not cover phone contacts, home visits or nursing home services.
APhA		American Pharmaceutical Association.
APR-DRG		All-Patient Refined DRGs. There are many diagnosis encoding schemes in use today in the healthcare industry. Many hospitals use both the DRG (required for Medicare reimbursement) and the APR-DRG (mandated by the state of California for hospital reporting), as well as ICD-9. APR-DRG is a further refinement of the DRG categories. DRGs focus on resource intensity and address a Medicare (geriatric, chronic) population. However, they do not address newborn and pediatric populations, disease categories like HIV infections and the treatment of trauma patients in sufficient detail. APR-DRGs were introduced to remedy this. Normally, DRGs are to be used for billing HCFA (Medicare, Medicaid, Child Health) and other insurance carriers. However, at many IHS, DRGs and APR-DRGs have been adopted as internal patient classification categories. APR-DRGs are a set of approximately 300 categories that can be assigned to a case after discharge. APR-DRGs are designed to be independent of complexity (COI), whereas DRGs inherently include complexity as part of what they define. Thus a finer gradation of diagnoses can be obtained by considering both the APR-DRG and the COI for a given case. By separating out COI, cases can be sorted independently by complexity and by APR-DRG. APR-DRGs expand the scope of DRGs to address patient severity of illness and risk of mortality as well as resource intensity. Under the APR-DRG system, a patient is assigned three distinct descriptors, • Base APR-DRG code (Diagnosis) • Complexity of Illness (Severity) • Risk of Mortality Morbidity
APTA		American Physical Therapy Association.
ARC		Alcoholism Rehabilitation Center. Also, AIDS Related Complex
ASA		Anesthesia Status Assessment.
ASC		Ambulatory Surgery Centers. They provide elective surgery on patients who can leave the surgery site in the same working day. These organizations are proliferating throughout the U.S. From 1980 to 1990, over 900 new ASCs opened for business. At present, mid-1996, there are more than 2,100 ASCs, and the numbers continue to escalate. Their growth is primed by the objective of costs savings, the Holy Grail of managed care. They accomplish this by taking advantage of the growing acceptance among physicians and patients of technological advances in minimally invasive surgical procedures.
ASCP		American Society of Consultant Pharmacists.
ASCPT		American Society for Clinical Pharmacology and Therapeutics.
ASHP		American Society of Health System Pharmacists.
ASIA		American Spinal Injury Association.
ASO		Administrative Services Only. A contract between an insurer and a self-insured group to provide administrative services. These services may include actuarial support, plan design, claims processing, data recovery and analysis, benefits communication, financial advice, medical care conversions, data preparation for governmental reports, and stop-loss coverage. [Courtesy of drkoop.com's Glossary of Insurance Terms]
ASP		Application Service Provider, such as scheduling.com.
Asymmetric Encryption		An encryption scheme in which information intended for an individual is encoded with his/her public key, but may only be decoded with his/her private key (generated from a guarded password).
Attest Station		The place where the physician reviews the coding for diagnoses and procedures and “attests” to its accuracy.
At Risk		A term that refers to the financial risk that is assumed by an organization or individual when providing healthcare. The group or individual is responsible for managing cost for that care and is therefore “at risk” for that cost.
AUB		Abnormal uterine bleeding. This is a relatively common condition characterized by especially heavy menstrual flows, or unexpected or prolonged bleeding.
Audiogram		The basic hearing test or audiogram tests one’s ability to hear pure tones in each ear. Best results are obtained by a trained audiologist in a special soundproof testing booth. Simple tests, such as ones done in many schools, may be useful for screening, but a careful audiogram is necessary for accurate diagnosis of most hearing problems. A complete audiogram will test both the bone conduction (the ability to hear a sound when it transmitted through bone) and the air conduction (the ability to hear a sound when it transmitted through air). A comparison between these two types of conduction can be very useful in localizing which part of the hearing mechanism is responsible for the loss. In particular, the test is useful in determining if the loss is due to a problems with the portion of the middle ear that conducts sound from the ear canal to the inner ear (in which case it would be called a “conductive” hearing loss) or if it is due to the inner ear or the nerve that conducts the sound signals to the brain (in which case it would be called a “sensorineural” hearing loss). The results of audiograms are most often displayed in graph form. This graph shows the amount of hearing loss expressed in units called decibels at different sound frequencies (also called Hertz). High frequencies correspond to high tones, and low frequencies are low tones. Most audiograms go from around 250 hertz to 8000 hertz. A loss up to 20 decibels on this graph is considered “normal.” Hearing losses over 20 decibels are considered abnormal. . [Source: Department of Otolaryngology-Head and Neck Surgery at the University of Washington School of Medicine]
Average Wholesale Price		Average Wholesale Price of a prescription drug.