Provided here are the most common terms used in medical billing and coding. Whenever possible, we have avoided “medical lingo” to avoid confusion for beginning medical billers and coders.
Common Medical Billing and Coding Abbreviations
- ABC – Advanced Contract Billing
- MCO – Managed Care Organization
- HHS – Health and Human Services
- EDI – Electronic Data Interchange
- HCPP – Health Care Prepayment Plan
- ANSI – American National Standards Institute
- HIPAA – Health Insurance Portability and Accountability Act (1996)
- GHP – Group Health Plan
- NAHDO – National Association of Health Data Organizations
- PPO – Preferred Provider Organization
- PSO – Provided Sponsored Organization
- EOB/COB – Explanation of Benefits/Coordination of Benefits
- NII – National Individual Identifier
- HMO – Health Maintenance Organization
- FDA – Food and Drug Administration
- ICD – International Classification of Diseases
- WHO – World Health Organization
Abstract
For medical billers and coders, an abstract is exactly what it sounds like – a small amount of information that is presented in either paper or electronic form. For example, an abstract could include information on a patient’s medical history during a short period of time. Abstracts are often used by insurance companies or health professionals to quickly view information about a patient before making a medical or financial decision.
Actual Charge
A large portion of medical billing involves comparing what a medical facility charges for a procedure (the actual charge) and what plans like Medicare will pay. So, for a medical biller, the actual charge does not constitute the charge after applying any health coverage payment (as it would be for the patient); rather, it represents the amount that the medical facility “actually” charges for the procedure – an important distinction.
Add-On-Code
Medical coding often requires the use of additional codes to provide insurance providers with more information on specific procedures that were performed on a patient, which are called add-on-codes. These codes are always applied to a primary care code. Sometimes, these codes denote a service that may not be covered by a patient’s insurance plan. For example, Aetna (a major medical organization), came to an agreement that the CPT add-on-codes 76082, 76083, 78478 and 78480 used in 2006 would not be considered for payment. These codes referred to CAD Mammography and Myocardial Perfusion Testing services.
Admitting Diagnosis Code
From time to time, the original diagnosis made by a medical professional will differ from the final diagnosis submitted for approval. The original diagnosis is still an important piece of information and is called the admitting diagnosis code. One example of why these codes are important involves emergency room visits. For example, chest pain could certainly justify a visit to the emergency room. However, the final diagnosis could be a hiatal hernia, a condition that does not justify emergency treatment. Without the admitting diagnosis code, it could appear that the patient sought emergency care when it was not necessary.
Advanced Contract Billing Codes
Also referred to as ABC Codes, advanced contract billing codes make up a set of around 11 million codes developed in 1996 to describe healthcare techniques not covered by the standard CPT system. Since their development, codes have been added to meet the coding needs of emerging medical techniques, such as alternative medicine. For example, 4,200 codes were added to cover treatments such as massage therapy, acupuncture, ayurvedic medicine, midwifery and homeopathy. As more and more insurance companies make the decision to offer plans covering these procedures, they are becoming more common in medical billing and coding training.
Advance Beneficiary Notice
Although not all that common in medical billing and coding, advance beneficiary notices do creep up from time to time and are very important for both the patient and healthcare coverage provider. An advance beneficiary notice is usually abbreviated as ABN and refers to a notice that a medical procedure or item will not be covered by Medicare. If a patient does not receive this notice prior to treatment and Medicare does not cover it, the patient will not be responsible for the cost. However, if the patient signs this notice prior to treatment, they will be responsible for the cost that their insurance provider does not cover.
Beneficiary
Medical care providers refer to patients that receive healthcare coverage through an insurance company or Medicare as beneficiaries. The term “beneficiary” is almost always used in medical settings when referring to these types of patients. For example, the CPT codes 99324-99337 refer to beneficiaries that receive care in their own living space, a rest home, or assisted living facility, among other locations. It is important to remember the distinction between patients that do not have access to healthcare coverage and beneficiaries, who do – at least in medical billing and coding terminology.
Claim
In general, a claim is defined as a specific request to an issuance company made by a patient (or on his or her behalf) regarding a payment for medical services. In the health insurance industry, medical billers will encounter claims as a part of their daily tasks, and a claim in this setting is nearly identical to any other insurance application (a claim for a car accident, for example). In some settings (such as Part A and B services), a claim can also be referred to as a bill.
Claim Adjustment Reason Codes
Medical billers and coders do not simply apply codes to conditions and treatments. In fact, there are whole sets of codes that identify a variety of situations that arise during medical care. Among these sets are the claim adjustment reason codes, which identify the reasons that differences arise between the amount charged for a service or item and the payment that was made by the payer. This national code set was created and is kept up to date by the Health Care Code Maintenance Committee. The most common usages of this code are in any X12 837 Claim or X12 835 Claim Payment and Remittance Advice transaction.
Claim Attachment
There are a wide variety of forms and records that accompany the actual claim for payment filed by a medical biller. These records or forms are referred to as claim attachments. There actually were no standards governing which claim attachments were necessary in which situations until the Federal Register published these standards in September of 2005. Interestingly, this same publication also adopted the Logical Observation Identifiers Names and Codes as the new official HIPAA code set to reference attachment information. Claim attachment codes are divided into six different types as well as special sets for businesses.
Claim Status Category Codes
Claim status category codes are part of a national code set that splits larger groups of codes into categories dealing with the status of a claim. The most common usage of these codes is in X12 277 Claim Status Notification transactions. When viewing these codes, it is evident how ever-changing the medical billing and coding world can be. In other words, many claim status category codes have start and end dates for their usage. One example is the now extinct Supplemental Message code X0 that began usage in January of 1995. This claim status category code was no longer used beginning in October of 2003. Other codes like A0 (showing that the claim has been forwarded to another individual) are still used and have been since 1995.
Claim Status Codes
Like claim status category codes, claim status codes make up a national code set created to organize the transactions that deal with claims – more specifically in the status of claims as they move along the insurance payment process. Each code is a number that corresponds with the claim status category code organizing it. Currently, there are 761 claim status codes in use by medical billers and coders. One distinction of claim status codes from the corresponding category codes is that claim status codes are more frequently updated by the Health Care Code Maintenance Committee.
CMS-1450
The CMS-1450 is an important form for medical billers and coders to understand – it is the primary form for billing of institutional charges billed to almost all Medicaid based state agencies. It is also commonly used to signify that a provider has qualified for a fee waiver from ASCA requirements on electronic submissions. This translates to sometimes saving money for your employer, which is always a positive thing. This form is designed by the National Uniform Billing Committee. One important thing to note with this form is that it has a color coding system that must be preserved; so, most medical institutions do not make their own photocopies of this form, instead purchasing it from authorized contractors.
CMS-1500
This form is to medical billers what the W9 tax form is to most of America – essential. The CMS-1500 is the primary form used to bill Medicare carriers and equipment manufacturers when the medical provider qualifies for a waiver on its service costs. Like the CMS-1450, this form uses a color coding system that is difficult to duplicate when copied on a standard photocopier – so most insurance carriers will not accept copies. The most common rule for this form is that it is printed using Flint OCR Red, J6983 ink (exact match). This form is usually purchased in bulk from the U.S. Government Printing Office but can be purchased legitimately from third party sources.
Code Set
This is the Bible of medical billers and coders, or the database of codes used in the coding industry. More specifically, this term can refer to the entire library of codes used in medicine, or any specific group of codes broken up to meet certain coding needs. For example, medical diagnostic codes, medical procedure codes, terms, and descriptions are all code sets in their own way, but they also make up the larger code set to rule all code sets. At larger medical institutions, medical billers and coders may work with only a single code set to accommodate high paperwork volumes. At smaller institutions, one medical billing and coding wizard may be responsible for knowing the majority of all of these codes.
Common Procedure Terminology (CPT)
The common procedure terminology is a code set that deals with, as the name suggests, the most common codes in medical billing and coding. Think of the CPT as your introductory course in medical billing and coding and, indeed, these are often the first codes that a medical coder will learn. This larger code set is split into three levels based on the codes’ individual context. Level I consists of entirely numeric codes defined by the AMA. Level II uses alphanumeric codes to describe services and items not covered by the basic CPT code set. Level III also uses alphanumeric codes but defines state specific items. These are sometimes called “local codes” and are recognizable as always having a W,X,Y, or Z as the first letter in the code.
Computer Matching Agreement
A computer matching agreement is a term used by many different industries. Luckily, the meaning is largely the same in each industry, including medical billing and coding. A computer matching agreement is a written document that compares information held by two different entities for two major purposes – eligibility verification with various laws and regulations in mind (especially when these regulations may conflict from entity to entity), and recovering a payment or overpayment that was made in error. Few medical organizations surrender money without extensive fact checking; this process is used to make the check faster and more accurate for all parties involved.
Coordination of Benefits
From time to time, a patient’s problem is not whether their health insurance provider will pay their medical bills, but which of the entities covering them will pay first. If one of the entities happens to be Medicare, the federal government makes the call. Otherwise, a program may be used by the healthcare provider to determine who pays the bill first. Medical billers and coders refer to this program as the coordination of benefits. This program is important for a variety of reasons. Most important to medical billers is the possibility of both insurance carriers paying the bill, which can be an administrative nightmare for all involved. The coordination of benefits serves to prevent this problem from occurring.
Covered Entity
A covered entity is an important term for medical billers and coders – it describes a healthcare provider, plan, or clearinghouse that regularly transmits health information related to HIPAA transactions. This can be a confusing designation. Indeed, the Administrative Simplification standards put into effect after the passage of HIPAA in 1996 included a series of flow charts designed to determine whether or not a plan, provider or clearinghouse qualified as a covered entity. This series of yes or no questions is designed to help the reader understand how to identify covered entities and, just as importantly, determine which entities were not covered.
Covered Services
While a covered entity refers to insurance providers, covered services are the other end of the spectrum – qualifying healthcare providers. Two different programs cover medical costs: SMI and HI. Covered services are not covered by HI programs and include nearly all physician services, ambulatory services, diagnostic tests, outpatient care, and DME. If a service or item is covered by the HI program, it is not considered a covered service in the medical billing and coding community; however, this does not mean that it will not be ultimately covered by an insurance provider.
D-Codes
Sometimes dental procedures are encountered by medical billers and coders – especially those that qualify as emergencies or require surgery. There are specific codes to describe all of these procedures, dental diagnoses, and items used in procedures. These D-Codes form a section of the larger code set called the HCPCS Level II. As the name would suggest, these codes begin with the letter “D” and are followed by a numeric code. One of the oldest D-Codes is the D0210, which indicates a periodic oral evaluation with an established patient. This code was first introduced on New Years Day in 1982.
Data Content
Data content is a special term used to describe all of the information involved in a medical administrative transaction, including all codes and data elements. However, this term is not used to describe the format of this information as it appears in the records and forms that medical billers and coders use. This term is frequently used to describe requirements set forth by HIPAA that determine claim eligibility. Organizations will often add supplemental data to compliment data content provided by a medical biller based on their own records of the patient, procedure or diagnosis. In this situation, only the original information provided by the medical biller is referred to as the data content.
Data Element
A data element is the smallest unit of information in medical billing and coding forms and records – commonly the codes themselves. Ever wonder why medical billing and coding is necessary? Data elements, and problems associated with them, are the primary reason for the development of this field. In common practice, a data element can become what researchers call “over loaded” meaning that these units can have multiple meanings when not in code form – a potentially dangerous problem. With a coding system, specific and non-interpretive definitions are assigned to a variety of entities, nearly eliminating the problem of data element over loading. Thus, data elements are indeed important to medical billers and coders.
Data Mapping
Medical billing and coding code sets are constantly evolving. In fact, we are on the verge of a new set of codes being implemented 2013 – ICD-10. But what happens to old medical records that used current codes at the time, but then need to be accessed for future billing reference or patient medical histories? Data mapping is the process of creating a link between old codes and new ones in the event that the old codes fall out of standard usage. When comparing two codes in data mapping, there are two different relationships – broad to narrow and equivalent. With an equivalent relationship, the two codes are used to describe the same entity. With broad to narrow relationships, the codes are more loosely related but can be used interchangeably to describe the same condition, item or diagnosis.
Designated Code Set
With the presence of several different code sets for the same general entities, a problem sometimes arises where different codes can be confusing during different stops in the medical billing transaction process. Sometimes, medical billers and coders will use a designated code set, or a required set of codes, for a record or transaction. In fact, the only thing preventing medical billers and coders from applying their own set of codes to diagnosis transactions is the existence of a large designated code set in standard practice – the ICD-9-CM. However, other subsets of codes do exist and sometimes require clarification or designation in some scenarios.
Diagnosis Code
There is a common misconception that diagnosis codes are only codes used to describe the condition a patient had when first accepted for treatment at a medical facility. However, diagnosis codes can be used to describe both the condition chiefly responsible for hospitalization and any additional conditions that were present at the time of hospitalization, or that developed later as a result of this admission and impacted the treatment received. For instance, a diagnosis code could be used to describe both a compound fracture (serious broken arm, for instance) and an infection that later set in as a result of the broken arm. A further diagnosis code could be applied if the patient was also suffering from the flu at the time and required special treatment because of this.
Direct Data Entry
Direct data entry is the information that is immediately entered into an electronic records system used by a medical biller and coder. This can be a confusing term, as it refers not to the practice of inputting the data, but to the information provided in this data. For example, Medicare requires direct data entry for medical billers and coders to send UB-92 claims, access revenue codes, and access reason codes. Direct data entry is processed electronically to expedite the transmission of time-sensitive information related to many medical billing and coding transactions. On the other hand, some transactions do not need direct data entry because the information is not time-sensitive or requires a special, color coded form.
DRG Coding
There is an important distinction between DRG Coding and DRGs, although both refer to codes – sometimes the same set. While DRGs are diagnosis related groups, DRG Coding is a code set used by healthcare providers on discharge billing. DRG coding is the subset of codes that denotes a medical professional’s final diagnosis of a patient. When this code is applied, medical billing takes over to determine how much services will cost, among other things. DRG coding is combined with other code sets like CPT to gain an overall statement of services. So, DRG coding cannot act on its own to determine how much medical services will cost and how much medical insurance plans will be billed for said services.
EDI Translator
One unfortunate reality when transmitting data between two entities is that, sometimes, one system will use data that the other system does not understand. Think of this like when you receive a strange file on your computer that your operating system does not recognize. This happens from time to time in medical billing and coding. An EDI translator is a program that translates the popular EDI format (electronic data interchange) to other file types for easy storage, transmission or manipulation. For example, an EDI translator could translate EDI to a text file or Excel file for Windows operating systems.
EDIT
An EDIT is what medical billers and coders call the process of selecting an individual claim and evaluating it. Most of the time, this evaluation is a comparison of the claim with other information in order to take some action in billing, such as paying the claim in full, in part, or suspending it. An EDIT is actually performed by a software system called the Standard Claims Processing System.
Electronic Data Interchange
Have you ever wondered what all of that stuff is before the web address at the top of your browser? HTTP stands for hyper text transfer protocol. If there is an “S” next to the HTTP, the added word is “secure.” This is one of the most recognizable forms of electronic data interchange. This concept really relates to any transmission of data from one computing device to another in a standardized format. In medical billing and coding, electronic data interchange is, of course, quite common. This term is usually used in administrative applications or diluted to the exact way that the data is transmitted to avoid confusion.
False Positives/Negatives
Medical billing and coding involves providing data on services rendered by a medical facility for the purposes of being reimbursed by an insurance carrier for those services. However, some problems can arise when preparing this data for ongoing claims (when a patient needs extended care and the insurance company makes regular flat payments, for example). A false negative exists when a medical record implies that a service was performed that was not present in the records of the ongoing treatment, which is most likely a mistake made by the medical provider and not malicious. However, a false positive shows a service that is being requested for payment but was not performed, based on the medical record. This is sometimes viewed by insurance carriers as being fraudulent.
Fiscal Intermediary
A fiscal intermediary is common in many more industries than medical billing and coding. In general, a fiscal intermediary is contracted by an insurance carrier (such as Medicare) to pay some bills and offer assistance on administrative tasks. In medical billing and coding applications, a fiscal intermediary usually pays all Part A bills and limited Part B bills. This entity is always a private company (not government run). The “fiscal” part is often dropped and the entity is referred to as an “intermediary” – but they perform the same function.
HCFA-1450
This common form in medical billing and coding is the primary document needed for the payer to process payments to a medical care provider – the payer usually being an insurance provider. The HCFA-1450 is also sometimes referred to as the UB-92. Most of the time, the form does not need to be filled out in its entirety – extra sections are provided for the details needed to process Medicare claims. This form is monitored and designed by the National Uniform Billing Committee. As with other forms, it is important that special paper and ink are used to make sure that the HCFA-1450 can be scanned properly by the claim payer – meaning that the form is usually specially ordered by the medical care provider.
HCFA-1500
The HCFA-1500 form is encountered by both the patient and medical care provider, with different sections filled out by each party. Sometimes, the medical care provider will fill out the entire form using information provided by the patient. Most of the time, the medical biller and coder will be responsible for the bottom portion, or sections G through J. This form is the standard uniform claim form, or the go-to form for insurance claims from Medicare.
Healthcare Provider Taxonomy Codes
This special code set is used to divide medical care providers into categories based on their specialization and type. Healthcare provider taxonomy codes are ten digits or letters in length and provide information on a variety of different topics. For example, an individual physician will have a different code than a larger healthcare provider like a hospital. Codes are also available for different levels of education, licensure and certification earned by the entity. The medical biller and coder will not assign a code to a medical care provider. Instead, the provider will choose the code that best represents their services. It is important to note that a healthcare provider can, and often will, have multiple healthcare provider taxonomy codes.
Healthcare Clearinghouse
A healthcare clearinghouse can be either private or public, and it performs a variety of roles. Most of the time, a healthcare clearinghouse handles information transmissions – turning non-standard data into standardized forms for ease of processing. However, this entity can also perform the opposite service, taking standard data and changing it to meet the data needs of the receiver.
Health Insurance Claims Number
This number is assigned to every beneficiary of Medicare and is used to quickly identify beneficiaries when they file a claim. The health insurance claims number is usually seven to eleven digits long and is split into two parts. The first section is used to identify the policy that the beneficiary has. The second portion shows the relationship between the person controlling the insurance policy and the beneficiary – especially important in family or business plans, for example.
HIPAA
The Health Insurance Portability and Accountability Act of 1996 set standards for healthcare transactions processed electronically. In essence, this act set the stage for standard practices still in use today by medical billers and coders. The first portion of the act actually had a different purpose, protecting insurance coverage for workers and their families when the worker changes or loses a job. The second portion of this act, referred to as the Administrative Simplification provisions, set guidelines for the protection and security of personal health data, which is one reason for the popularization of medical billing and coding in the late 1990s.
ICD
One of the most well known code sets for medical billers and coders is the ICD-9-CM, or the International Classification of Diseases set forth by the World Health Organization. The International Classification of Diseases is used to prepare a variety of data, including mortality rates from various diseases. The first publication of the ICD by the World Health Organization was in the 1850s. However, this list was first adopted by the International Statistical Institute in 1893. The number after ICD corresponds with the current version of the code set, or revision. The current revision is 9. However, ICD-10 will be put into full usage by 2013.
J-Codes
One of the thorns in the side of medical billers and coders is the problem of J-Codes. These codes are used to signify that an injected drug was used on the patient. However, some J-Codes also refer to a few oral immunosuppressive medications. The main problem with J-Codes involves the fact that these codes also indicate that a standard dose was used without any further details. Most medical billers and coders are forced to enter a miscellaneous J-Code followed by a manual cost of the dose, which can make it difficult to keep accurate dosage and pricing records. A further problem with J-Codes is that injected drugs are almost always furnished by the medical care provider, not a pharmacy. For this reason, most medical billers and coders use NDC (National Drug Code) as the chosen coding method.
Local Codes
Usually descriptive of HCPCS Level III coding, local codes are fairly simple in that they are used to define the geographical location of the payer, usually at the state level. However, there are local codes designated for smaller areas, particularly in metropolitan zones. Beyond HCPCS Level III, these codes can also apply to Institutional Revenue Codes, Value Codes and Condition Codes, among others.
Managed Care Organization
Two major concerns exist in the United States health industry from the patient’s perspective – to increase the quality of medical care available and to reduce the cost of this care. This is where managed care organizations come in. These organizations exist to benefit Medicaid or Medicare beneficiaries based on their risk. The most common plan offered by a managed care organization is the HMO, but other plans include PPO and POS. The HMO (Health Maintenance Organization) offers access to a group of physicians or hospitals in exchange for a subscription-based fee paid by the beneficiary. All HMOs are state licensed organizations.
Medicare
Most workers in the United States, in addition to giving up a portion of their paycheck to federal and state taxes, will notice a fee for Medicare. This fee contributes to a health insurance program specifically designated for senior citizens over the age of 65, some young persons that suffer from a disability, and those with certain forms of renal disease (advanced kidney failure).
Medicaid
While Medicare assists senior citizens and those with physical disabilities, Medicaid assists another growing demographic – those with low incomes or limited medical resources. States define exactly which procedures and overall medical costs are covered under Medicaid, and reduced state budgets can mean less coverage for patients that qualify. However, some patients qualify for both Medicaid and Medicare plans in their state and thus have access to coverage for nearly all medical procedures, treatments and associated materials.
National Drug Code
This special code subset is maintained by the Food and Drug Administration and is a federal level set of codes used to identify drugs that have been approved by the FDA. This is an essential code set for medical billers and coders, especially when drugs are distributed as part of an in-patient treatment plan and must be reimbursed to the medical care facility by an insurance provider. As all FDA approved drugs are assigned a code in this subset, and the FDA regularly approves new drugs, this code set is one of the most constantly changing sets in the medical billing and coding industry, making it vital that the biller or coder stay up to date on new codes.
National Patient ID
This identification number is assigned to all persons that receive healthcare services, and it is unique to each patient. It is often called the NII (or National Individual Identifier). The development of the National Patient ID actually caused a bit of controversy. In 2008, the Rand Corporation spoke out against the new ID stating that the proposed ID would “violate patient rights, privacy rights and constitutional rights.” Their primary fear was that such a unique identifier would leave patients susceptible to unsolicited contact from private organizations and leave an opening for data mining and comparisons to advertise medical products to patient groups.
National Payer ID
Like the national patient ID, the national payer ID is a code assigned to each organization that actively makes payments for healthcare services on the behalf of beneficiaries. There is an important distinction in that these codes are not commonly applied to individual patients that pay their own medical bills; rather, they are usually only applied to organizations such as private and public insurance companies and providers.
National Uniform Billing Committee
This organization is responsible for monitoring and maintaining the various forms used by medical billers and coders for billing purposes, such as the UB-92 or HCFA-1450. The National Uniform Billing Committee is chaired by the American Hospital Association. This organization is governed by HIPAA and monitors not just the forms used in medical care transactions by medical billers and coders, but also often the transactions themselves.
National Uniform Claim Committee
The sister organization to the National Uniform Billing Committee, the National Uniform Claim Committee monitors and maintains forms like the HCFA-1500, or forms used in the processing of insurance claims. Their primary responsibility is to verify and standardize data presentation on these forms. This organization also maintains a special code set, the Provider Taxonomy Codes.
Payer
This is a broad term used to describe any organization that offers to pay for medical treatment on the behalf of a beneficiary. In doing this, these organizations are taking on a risk that can often come with an increased cost for some beneficiaries. For example, a person that is at a higher risk for cancer or heart disease due to lifestyle choices or pre-existing health conditions may be a higher risk for a payer, and may thus be required to pay a higher subscription fee for the insurance. Payers assume that this individual will require more payments for healthcare services than a person not displaying these health risks. It is important to note that a payer can also be a patient that covers their own medical costs without assistance, or an employer that has their own insurance plan.
Postpayment Review
Sometimes a payment will need to be reviewed after it is completed. This process, called the postpayment review, can occur for a variety of reasons. Chief among these reasons is a situation when a patient returns for medical care and their medical records must be reviewed. However, postpayment reviews also occur to verify that the correct reimbursement has been made for medical care costs.
Revenue Code
This code is essential to medical billers and coders, as its absence from a bill could prevent a claim from being paid. In general, revenue codes indicate the patient’s location when they were treated or what items the patient received as part of their treatment. Revenue codes are three digits in length and correspond with procedure codes. One example of a revenue code is 450, which means that the patient was treated in the emergency room. Paired with the CPT code 99282, the full code (99282-450) would indicate that the patient arrived at the emergency room of a hospital with a condition of up to moderate severity, and was treated there.
Standard Claims Processing System
This term is used to describe the computer system used to process claims (usually claims to Medicare). The name of the system can differ depending on the data used. For example, laboratory claims use a system called Electronic Data Systems. On the other hand, supplier claims are prepared by the Viable Information Processing System.
X12
X12 is a body that forms the standards for Electronic Data Interchange, or EDI. X12 is often accompanied by the prefix ANSI, which stands for the American National Standards Institute. X12 is not just associated with medical billing and coding. In fact, X12 has been involved with transportation, finance, and government institutions, among others.
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