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What Does THAT Mean? - Breaking the Code
By Janabeth Fleming Taylor, R.N., R.N.C.

Everyday we are faced with a "code" of some sort, no matter what area of law we work in. It may be a special abbreviation used to denote an expert's credentials, or shorthand for an engineering term. Or even a specialized term we can not find defined in a traditional dictionary. It may be a shortened spelling of a word, an abbreviation. Or, it may be an acronym.

An acronym is a kind of abbreviation. The word comes from Greek, meaning heads of names. Acronyms are usually made from the capitalized initials of the words it represents, for example FBI is an acronym for the Federal Bureau of Investigation.

Occasionally, for special reasons, the second letter of a word is used, as in XML (eXtensible Markup Language). Sometimes more than one letter is included for a word, to avoid ambiguity or because they form an existing abbreviation, as in SACEUR (Supreme Allied Commander, Europe).

Contrary to what some sources say, acronyms do not have to be pronounceable words (for example FBI is spelled out when spoken, whereas NASA is not). Some sources use the word initialism to refer to the spelled acronyms.

The medical and billing records of the client are filled with specialized abbreviations and acronyms that may provide crucial information related to the client's claim. Even data reports referencing chemicals, specialized tests, and laboratory results come in "code".

What is one to do when faced with the challenge of the "code"? There are various resources available on the internet with more arriving daily. I have made an attempt to summarize some of the various resources available.

If you are not able to "crack" the "code", it is advised you ask the entity providing the data where the "code" is found with a key or list of approved codes to enable you to clearly translate the document.

Be aware that some abbreviations are regional, with differing abbreviations actually meaning the same thing. For example in medicine TKO and KVO mean the same thing, to run an IV at a rate that is just fast enough to overcome vascular resistance and keep the vein open (TKO = to keep open, KVO = keep vein open).

Below are various sites available to assist in "breaking the code".

Part One - Medical Abbreviations - Acronyms - General

  1. International Medical Abbreviations:

    http://www.wyeth.co.uk/resources/med_main.htm

  2. General Medical Abbreviations Look up:

    1. http://www.wyeth.co.uk/education/eduhome.htm

    2. Use the medical dictionary to look up the meaning of common medical terms, abbreviations, and medical names. This dictionary includes terms from diseases, symptoms, treatments, diagnostic tests, and many other medical terms. http://www.wrongdiagnosis.com/lists/dictaz.htm

    3. Medical Malpractice Terminology/Dictionary http://www.wrongdiagnosis.com/malpractice/dictionary.htm

    4. List of Medical Acronyms and Abbreviations http://www.wrongdiagnosis.com/lists/acronymns.htm

  3. Pathology Abbreviation Look up:

    Pathologists use lots of abbreviations and acronyms. An acronym is an abbreviation of a phrase, where each letter of the acronym is added consecutively from the first letter of each of the words of the phrase. An abbreviation is a shortened form of a text-string, and all acronyms are types of abbreviations. The following is a list of over 12,000 abbreviations used in medicine: http://www.euspirit.org/en/upload/984528174.37955/abbtwo.htm

  4. JACHO/ Institute for Safe Medication Practices - Listing of dangerous and prohibited abbreviations

    1. By the end of 2004, JCAHO expected full compliance in all handwritten, print, and electronic media documents related to these dangerous abbreviations. Further details are available on the JCAHO Web site: http://www.jointcommission.org/NewsRoom/NewsReleases/nr_012506.htm

    2. In addition, the Institute for Safe Medication Practices (ISMP) has published a list of dangerous abbreviations relating to medication use that it recommends should be explicitly prohibited. It is available on the ISMP Web site: http://www.ismp.org/Tools/errorproneabbreviations.pdf

  5. Acronym Glossary - Medical & Professional Degrees & Credentials

    http://www.sandiegobizmart.com/tools/t3_acronym_glossary.htm

  6. Nursing Credentials/Acronyms

    A
    AAS: Associates' Degree Applied Science
    ACNP: Acute Care Nurse Practitioner
    ACLS: Advanced Cardiac Life Support
    ACRN: AIDS Certified Registered Nurse
    ANP: Adult Nurse Practitioner
    AOCN: Advanced Oncology Certified Nurse
    APN: Advanced Practice Nurse
    ARNP: Advanced Registered Nurse Practitioner
    ASN: Associates' Degree in Nursing
    B
    BC: Board Certified
    BCLS; BLS: Basic Cardiac Life Support
    C
    C: C - connotes certification in a specialty area by the American Nurses' Credentialing Center in one of several generalist and specialist practice areas.
    C-SPI: Certified Specialist in Poison Information
    CANP: Certified Adult Nurse Practitioner
    CAPA: Certified Ambulatory Perianesthesia Nurse
    CARN: Certified Addictions Registered Nurse
    CARN-AP: Certified Addictions Registered Nurse--Advanced Practice
    CCCN: Certified Continence Care Nurse
    CCM: Certified Case Manager
    CCNS: Certified Clinical Nurse Specialist
    CCRN: Certified Critical Care Registered Nurse
    CDDN: Certified Developmental Disabilities Nurse
    CDE: Certified Diabetes Educator
    CDMS: Certified Disability Management Specialist
    CDN: Certified Dialysis Nurse
    CDONA/LTC: Certified Director of Nursing Administration in Long-Term Care
    CEN: Certified Emergency Nurse
    CFRN: Certified Flight Registered Nurse
    CGA: Certified Gastroenterology Associate
    CGN: Certified Gastroenterology Nurse
    CGRN: Certified Gastroenterology Registered Nurse
    CGT: Certified Gastroenterology Technician
    CHN: Certified Hemodialysis Nurse
    CHPN: Certified Hospice and Palliative Nurse
    CHRN: Certified Hyperbaric Registered Nurse
    CHT: Certified Hemodialysis Technician
    CIC: Certified in Infection Control
    CLNC: Certified Legal Nurse Consultant
    CM: Certified Midwife
    CMCN: Certified Managed Care Nurse
    CMDSC: Certified MDS Coordinator
    CNA: Certified Nursing Assistant
    CNA: Certified in Nursing Administration
    CNA-A: Certified Nursing Assistant--Advanced
    CNAA: Certified in Nursing Administration, Advanced
    CNLCP: Certified Nurse Life Care Planner
    CNM: Certified Nurse-Midwife
    CNN: Certified Nephrology Nurse
    CNNP: Certified Neonatal Nurse Practitioner
    CNOR: Certified Nurse, Operating Room
    CNRN: Certified Neuroscience Registered Nurse
    CNS: Clinical Nurse Specialist
    CNSN: Certified Nutrition Support Nurse
    COCN: Certified Ostomy Care Nurse
    COHN: Certified Occupational Health Nurse
    COHN-S: Certified Occupational Health Nurse--Specialist
    COHN-S/CM: Certified Occupational Health Nurse--Specialist/Case Manager
    COHN/CM: Certified Occupational Health Nurse/Case Manager
    CORLN: Certified Otorhinolaryngology and Head/Neck Nurse
    CPAN: Certified Postanesthesia Nurse
    CPDN: Certified Peritoneal Dialysis Nurse
    CPHQ: Certified Professional in Health Care Quality
    CPN: Certified Pediatric Nurse
    CPNA: Certified Pediatric Nurse Associate
    CPNL: Certified Practical Nurse--Long-Term Care
    CPNP: Certified Pediatric Nurse Practitioner
    CPON: Certified Pediatric Oncology Nurse
    CPSN: Certified Plastic Surgical Nurse
    CRN: Certified Radiologic Nurse
    CRNA: Certified Registered Nurse Anesthetist
    CRNFA: Certified Registered Nurse, First Assistant
    CRNI: Certified Registered Nurse Infusion
    CRNL: Certified Registered Nurse--Long-Term Care
    CRNO: Certified Registered Nurse in Ophthalmology
    CRNP: Certified Registered Nurse Practitioner
    CRRN: Certified Rehabilitation Registered Nurse
    CRRN-A: Certified Rehabilitation Registered Nurse--Advanced
    CTN: Certified Transcultural Nurse
    CUA: Certified Urologic Associate
    CUCNS: Certified Urologic Clinical Nurse Specialist
    CUNP: Certified Urologic Nurse Practitioner
    CURN: Certified Urologic Registered Nurse
    CVN: Certified Vascular Nurse
    CWCN: Certified Wound Care Nurse
    CWOCN: Certified Wound, Ostomy, and Continence Nurse
    D
    DNC: Dermatology Nurse Certified
    DNS: Doctorate, Nursing Science
    E
    ENPC: Emergency Nursing Pediatric Course
    ET: Enterostomal Therapist (Now Wound, Ostomy, Continence Nurse)
    F
    FAAN: Fellow, American Academy of Nursing
    FAAPM: Fellow, American Academy of Pain Management
    FCCM: Fellow, American College of Critical Care Medicine
    FNC: Family Nurse Clinician
    FNP: Family Nurse Practitioner
    FPNP: Family Planning Nurse Practitioner
    FRCNA: Fellow, Royal College of Nursing, Australia
    G
    GNP: Gerontological Nurse Practitioner
    GPN: General Pediatric Nurse
    H
    HHA: Home Health Aide
    I
    IBCLC: International Board Certified Lactation Consultant
    L
    L.Ac.: Licensed Acupuncturist
    LCCE: Lamaze Certified Childbirth Educator
    LNC: Legal Nurse Consultant
    LNCC: Legal Nurse Consultant Certified
    LPN: Licensed Practical Nurse
    LSN: Licensed School Nurse (In Minnesota)
    LVN: Licensed Vocational Nurse
    M
    MICN: Mobile Intensive Care Nurse
    MN: Masters' Degree in Nursing
    MSN: Masters' Degree in Nursing
    N
    NCSN: National Certified School Nurse
    NICN: Neonatal Intensive Care Nursing
    NNP: Neonatal Nurse Practitioner
    NP: Nurse Practitioner
    NP-C: Nurse Practitioner, Certified
    NPP: Psychiatric Nurse Practitioner
    O
    OCN: Oncology Certified Nurse
    OGNP: Obstetric/Gynecology Nurse Practitioner
    ONC: Orthopaedic Nurse Certified

    P
    PHN: Public Health Nurse
    PMHNP: Psychiatric Mental Health Nurse Practitioner
    PNP: Pediatric Nurse Practitioner

    R
    RN: Registered Nurse
    RN,C: Registered Nurse, Certified
    RN,CS: Registered Nurse, Certified (Clinical) Specialist

    T
    TNCC: Trauma Nursing Course Certified
    TNS: Trauma Nurse Specialist

    W
    WHNP: Women's Health Care Nurse Practitioner
    WOCN: Wound, Ostomy, Continence Nurse
  7. Dictionary of Initials, Acronyms, and Abbreviations Used by Counselors and Social Workers

    http://www.counselingseattle.com/initials.htm

  8. Abbreviations - International Federation of Medical Students Association

    http://www.ifmsa.org/about/abbreviations.php

  9. Stanford School of Medicine - Department of Medicine Resource Guide - Abbreviation Resource

    http://ostinato.stanford.edu/acronyms/alpha.asp?F

  10. Abbreviations used in documentation for those with diabetes

    http://www.diabetesmonitor.com/r03.htm

  11. Medical and Pharmaceutical Spell Checker - Check the spelling of words online, also includes a link to look up medical abbreviations

    http://spellex.com/speller.htm

  12. Abbreviations commonly used in writing prescriptions:

    a.c. : before meals (Latin: ante cibum)
    b.i.d. : twice daily (Latin: bis in die)
    b.i.n. : twice nightly (Latin: bis in noctus )
    c : with (Latin: cum)
    cap : capsule (Latin: capsula)
    d : day (Latin: dies)
    daw : Dispense as written, no substitutions
    gtt : drop (Latin: gutta)
    h.s. : bedtime (Latin: hora somni)
    noxt : at night
    O.D. : Right eye (Latin: oculus dexter)
    O.S. : Left eye (Latin: oculus sinister)
    O.U. : Each eye (Latin: oculus uterque)
    p.c. : After meals (Latin: post cibum)
    pil : Pill (Latin: pilula)
    p.o. : By mouth (Latin: per os)
    p.r.n. : As needed (Latin: pro re nata)
    q.d. : Every day (Latin: quaque die)
    q.h. : Every hour (Latin: quaque hora)
    q.2h. : Every two hours (Latin: quaque secunda hora)
    q.3h. : Every three hours (Latin: quaque tertia hora)
    q.4h. : Every four hours (Latin: quaque quarta hora)
    q.q.h. : Every four hours (Latin: quaque quarta hora)
    q.6h. : Every six hours (Latin: quaque sex hora)
    q.8h. : Every eight hours (Latin: quaque octa hora)
    q.i.d. : Four times per day (Latin: quater in die)
    q.s. : As much as is required (Latin: quantum sufficit)
    s. : Without (Latin: sine)
    s.o.s. : If necessary (Latin: semis)
    ss : Half (Latin: sine)
    t.d.s : To be taken three times daily (Latin: ter die sumendum)
    t.i.d. : Three times a day (Latin: ter in die)
    t.i.n. : Three times a night (Latin: ter in nocte)
    ut. dict. : As directed (Latin: ut dictum)
  13. Acronyms Frequently Used in Special/Gifted Education

    This list is not comprehensive; it is intended as a quick reference.

    http://ericec.org/fact/acronyms.html

  14. Dictionary for Parents of Children with Disabilities - Download from this site:

    http://www.usd.edu/cd/publications/dictionary.cfm

  15. Acronyms in the Helping Professions

    Here is a helpful list of some of the more common abbreviations and acronyms. The designations are broken down into several categories for your convenience. Many professionals will list both a license and a national certification. For example, a professional counselor may place both LPC (for Licensed Professional Counselor) and NCC (for Nationally Certified Counselor) after his/her name and degree.

    http://www.encouragementplus.com/acronyms.html

  16. Physical Therapy Acronyms and Abbreviations

    http://physicaltherapy.about.com/od/abbreviationsandterms/a/PTabbreviations.htm

  17. Various Departments of Disabilities, Aging and Independent Living - these agencies use a number of acronyms and abbreviations to describe its services and programs. The following list from the Department of Disabilities-Vermont includes some of the more common:

    http://www.dad.state.vt.us/DSwebsite/facts/acronyms.html

    And this listing is from the U.S. Deparment of Health and Human Services

    http://aspe.hhs.gov/daltcp/acronym.shtml

    Acronyms in Aging - AARP - This guide, published in 2005, identifies acronyms commonly used in the field of aging and provides brief descriptions of the entities to which they refer. The downloadable guide is found here:

    http://www.aarp.org/research/reference/agingtrends/aresearch-import-881.html

Part Two: Medical Diagnosis/Code- Acronym Look Up

  1. ICD codes (Think of it as "Diagnosis" Code)

    http://www.cdc.gov/nchs/icd.htm

    The International Classification of Diseases (ICD) is the classification used to code and classify mortality data from death certificates.

    The International Classification of Diseases, Clinical Modification (ICD-9-CM) is used to code and classify morbidity data from the inpatient and outpatient records, physician offices, and most National Center for Health Statistics (NCHS) surveys.

  2. CPT Codes -Current Procedural Terminology (Think of it as "Procedure Code" upon which reimbursement is determined)

    https://catalog.ama-assn.org/Catalog/cpt/cpt_search.jsp?checkXwho=done

    CPT Codes describe medical or psychiatric procedures performed by physicians and other health providers. The codes were developed by the Health Care Financing Administration (HCFA) to assist in the assignment of reimbursement amounts to providers by Medicare carriers. A growing number of managed care and other insurance companies, however, base their reimbursements on the values established by HCFA.

    Since the early 1970s, HCFA has asked the American Medical Association (AMA) to work with physicians of every specialty to determine appropriate definitions for the codes and to try to determine accurate reimbursement amounts for each code. Two committees within AMA work on these issues: the CPT Committee, which updates the definitions of the codes, and the RUC (Relative Value Update Committee), which recommends reimbursement values to HCFA based on data collected by medical societies on the going rate of services described in the codes.

  3. Medicare Unique Physician Identification Numbers (UPIN) - UPIN is a six-position alphanumeric identifier that is assigned to all Medicare physicians, medical groups and non-physician practitioners

    UPIN are assigned as follows:

    1. Physicians (Medical Doctors) begin with A - M
    2. Limited License Practitioners, e.g., Chiropractors, Dentist, etc, begin with T - V
    3. Non-Physician Practitioners, e.g., Anesthesia Assistants, Physician Assistants, Clinical Nurse Practitioners, etc, are assigned P -S
    4. Group Entities, e.g., Ambulance, Independent Physiological Lab, etc, are assigned W - Y
    5. See below for the applicable Credential Codes:

      AA : Anesthesia Assistant
      AMB : Ambulance Service Supplier
      ASC : Ambulatory Surgical Center
      AU : Audiologist
      CH : Chiropractor
      CNA : Certified Nurse Anesthetist
      CNM : Certified Nurse Midwife
      CNS : Certified Clinical Nurse Specialist
      CP : Clinical Psychologist
      CSW : Clinical Social Worker
      DDM : Doctor of Dental Medicine
      DDS : Doctor of Dental Surgery
      DO : Doctor of Osteopathy
      DPM : Podiatrist
      FNP : Family Nurse Practitioner
      GRP : Group
      IDF : Independent Diagnostic Facility
      IPL : Independent Physiological Lab
      LAB : Laboratory
      MD : Medical Doctor
      MSC : Mammography Screening Center
      NP : Nurse Practitioner
      OD : Doctor of Optometry
      OT : Occupational Therapist
      PA : Physician Assistant
      PHS : Public Health Service
      PSY : Psychologist
      PT : Physical Therapist
      PXS : Portable XRay Supplier
      RNA : Certified Registered Nurse
  4. Code Modifiers for Alternative Medicine - ABC codes and terminology are maintained and developed annually as consumers, individual practitioners, practitioner associations and other health industry organizations submit code requests that reflect current practices in alternative medicine, nursing and integrative healthcare. This is an attempt to fill in the "gaps" left from other coding, and is done to support research and compile data by practioner type. These include treatment by massage therapists, acupuncturists, etc. These may not be seen in traditional billing records, but may be referenced in charting or other records obtained from non-traditional medical sources: http://www.alternativelink.com/ali/abc_codes/code_mode.asp

Part Three: General References

  1. General Acronym Look Up

    This is a neat tool for when you need to know what a special Acronym means. What is great about this electric dictionary is it returns a list of appropriate matches, BUT lets you further sort by categories such as : Most common (default), information technology, military/government, science/medicine, organizations, slang/chat, etc.

    http://www.acronymfinder.com/

  2. Abbreviationz (from a-z on the net) - Search or browse more than 305,000 abbreviations or acronyms. You can create and maintain your own list of terms.

    http://www.stands4.com/

  3. Acronyma- Database of more than 460,000 acronyms and abbreviations. Results can be displayed alphabetically or according to "importance". Also can search in several languages

    http://www.acronyma.com/

  4. The WorldWideWeb Acronym and Abbreviation Server - This site has acronyms and their expansions.

    http://acronyms.silmaril.ie/cgi-bin/uncgi/acronyms

  5. Investigative Resources - Investigative Resources International has maintained this database since 1995 as a service to the investigative and legal communities. They are continually updating and improving the site with selected links to searchable databases and research sites. Open and Public record sources from the US as well as foreign countries are included.

    http://www.factfind.com/public.htm

  6. General Reference "Bookshelf" Great source of references to all kinds of information - abbreviations, definitions, standards, codes, travel, media..you name it ..it's here!

    http://www.ecoplan.org/general/referenceshelf.htm

  7. Governmental/Military Acronyms

    The Federal Government tends to use abbreviations and special terms a great deal in their documentation. This is a listing of some from the Department of Defense and VeteranŐs Affairs

    http://www.pbm.va.gov/PBM/acronyms.pdf

  8. Compendium of Environmental Acronyms - Association of Engineering Geologists

    http://web.umr.edu/~aeg/arco/arco.html

  9. Electronic and Engineering Acronyms and Abbreviations

    http://www.interfacebus.com/Engineering_Acronyms.html

  10. CAS (Chemical Society of America) - Standard Abbreviations and Symbols

    http://www.cas.org/ONLINE/standards.html#listinga

  11. Chemical look up by abbreviation or name, with links out to data sheets, MSDS sheets and other information.

    http://www.chemfinder.com

  12. National Weather Service - Weather Acronyms

    http://www.srh.weather.gov/jetstream/append/acronyms_a.htm

  13. Abbreviations and Acronyms of the U.S. Government

    http://www.ulib.iupui.edu/subjectareas/gov/docs_abbrev.html

  14. Glossary of Internet Abbreviations: Email and Chat Shorthand:

    Part One: http://netforbeginners.about.com/cs/netiquette101/a/abbreviations_p.htm

    Part Two: http://netforbeginners.about.com/cs/netiquette101/a/abbreviations_2.htm

    Part Three: (emoticons/smilies) http://netforbeginners.about.com/cs/netiquette101/a/bl_emoticons101_2.htm

Remember, there may be more than one definition of the "code" you are trying to "break". You have to consider the context in which it is used, the setting and even the region of the country. These resources are only meant to be a guide, taking into account new resources are added daily as well as others are being discontinued.

Janabeth F. Taylor, R.N., R.N.C. has a degree in Nursing from Oklahoma State University and Litigation Paralegal Certificate from the University of Oklahoma Law Center. She was a nursing instructor for ten years and has been a medical legal consultant since 1990. Ms. Taylor is currently President/Owner of Attorney's Medical Services, Inc. in Corpus Christi, TX.

In 2002 she was named the Association of Trial Lawyers of America's Paralegal of the Year. She provides litigation support for attorneys across the United States and specializes in case reviews and Internet information resources. Her website is http://www.attorneysmedicalservices.com and her e-mail address is jana@attorneysmedicalservices.com


P.O. Box 181268 - Corpus Christi, TX 78480-1268
Email: jana@attorneysmedicalservices.com
Tel: 361/949-8880 - Fax: 361/949-8886


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