AC AD&D ADJ AE AFO AK ALLER ALS BID BIN c Cap CPhT CPM CTLSO D DAW Day Supply DME DOA DOB DOH DOI DOR DOS DR DUR EA ELR EO EOB EQUIP Before Meals Accidental Death and Dismemberment Adjuster Above Elbow Ankle Foot Orthosis Above Knee Allergies Advanced Life Support Twice a day Twice a Night With Capsule Certified Pharmacy Technician Continuous Passive Motion Cervical Thoracic Lumbar Sacral Orthotic Day Dispense as Written Number of Days a Prescription Is Expected to Last Durable Medical Equipment Date of Accident Date of Birth Days of Medication on Hand Date of Injury Date of Referral Date of Service Doctor Drug Utilization Review Each Elevated Leg Rest Elbow Orthosis Explanation of Benefits Equipment 2011 PMSI, Inc. All rights reserved. C1351-1211-02 PAGE 1 of 5
EQUIV EXTD FA FE FES FU FWW FX gtt HCFA HCPCS HDCP Hemi Walker HHA HHC HHS HI/LOW HKAFO HME HO HS ICD-9 IF IM IME INS IPPB IV IW KAFO KO LB Equivalent Extended Fixed Arm Full Electric Functional Electrical Stimulation Follow Up Front-Wheeled Walker Fracture Drops Health Care Financing Administration Healthcare Common Procedure Coding System Hospital Discharge Planner Half-Height, Foot-Propelled Walker Home Health Aide Home Health Care Hand-Held Shower Height Adjustable Hip Knee Ankle Foot Orthosis Home Medical Equipment Hip Orthosis Bedtime International Classification of Diseases Interferential Intramuscular into the Muscle Independent Medical Examination Insurance Intermittent Positive Pressure Breathing Intravenous into the Vein (Infusion Therapy) Injured Worker Knee Ankle Foot Orthosis Knee Orthosis Leg Bag 2011 PMSI, Inc. All rights reserved. C1351-1211-02 PAGE 2 of 5
LMN LOA LPN LR LSO LT WT LTD MEDS Mg ml MOS MSA MSP N/A NCM NDC NMS NPWT OD O&P OS OT OU PARA PBM PC PharmD PICC Line Pil PO PPD PPO Letter of Medical Necessity Letter of Authorization Licensed Practical Nurse Leg Rest Lumbar Sacral Orthosis Light Weight Long-Term Disability Medications Milligram Milliliter Months Medicare Set-Aside Medicare Secondary Payer Not Available Nurse Case Manager National Drug Neuromuscular Stimulator Negative Pressure Wound Therapy Right Eye Orthotics and Prosthetics Left Eye Occupational Therapy In each Eye Paraplegic Pharmacy Benefit Manager After Meals Registered Pharmacist with a Doctorate in Pharmacy Degree Peripherally Inserted Central Catheter Pill By Mouth Permanent Partial Disability Preferred Provider Organization 2011 PMSI, Inc. All rights reserved. C1351-1211-02 PAGE 3 of 5
PRN P/T PTD QA QAM QD QH QID QOD Q3H or Q3 Q4H or Q4 Q6H or Q6 Q8H or Q8 Q12H or Q12 Q24H or Q24 QUAD REF Rehab REQ RN RPH RTS RX s SAWW SE (or SEMI) SELFCONT SEO SEWHO SL S/N SO As Needed Physical Therapy Permanent Total Disability Quality Assurance Every Morning Every Day Every Hour Four Times a Day Every Other Day Every Three Hours Every Four Hours Every Six Hours Every 8 Hours Every 12 Hours Every 24 Hours Quadriplegic Referral Rehabilitation Request Registered Nurse Registered Pharmacist Raised Toilet Seat Pharmacy Prescription (or Script) Without Statewide Average Weekly Wage Semi-Electric Self-Contained Shoulder Elbow Orthosis Shoulder Elbow Wrist Hand Orthosis Under the Tongue Skilled Nursing Shoulder Orthosis 2011 PMSI, Inc. All rights reserved. C1351-1211-02 PAGE 4 of 5
SOC SOJ SR SSDI SSN STD SVC S/W SX TAB TENS TID Tsp Tbsp 3-in-1 TLSO TPA TPD TRANS TTB TTD TX U&C VR WC WCRC Start of Care State of Jurisdiction Side Rails Social Security Disability Insurance (Benefits) Social Security Number Short-Term Disability Service Spoke With Surgery Tablet Transcutaneous Electrical Nerve Stimulation Three Times a Day Teaspoon Tablespoon Bedside Commode, Raised Toilet Seat and Bath/Shower Chair Thoracic Lumbar Sacral Orthosis Third-Party Administrator Temporary Partial Disability Transportation Tube Transfer Bench Temporary Total Disability Transfer Usual and Customary Vocational Rehabilitation Workers Compensation Workers Compensation Review Center 2011 PMSI, Inc. All rights reserved. C1351-1211-02 PAGE 5 of 5