Arizona Administrative Code: State regulations established pursuant to relevant statutes. For purposes of this document, the relevant sections of the AAC are referred to throughout this website as "AHCCCS Rules."
AAR
Arizona Administrative Register
ABA
Applied Behavior Analysis
ACA
Affordable Care Act
ACC
AHCCCS Complete Care
ACE
AHCCCS Customer Eligibility: A computer system that determines eligibility for ALTCS, SSI MAO, KidsCare and other AHCCCS programs. The eligibility system was
retired in September 2018 and replaced with Health-e-Arizona Plus.
ACES
Adverse Childhood Experiences
ACH
Automated Clearing House
ACOIHC
Advisory Council on Indian Health Care
ACOM
AHCCCS Contractors Operation Manual
ACT
Assertive Community Treatment
ACTS
Automated Change Tracking System
ACW
Attendant Care Worker
ADE
Adverse Drug Event
ADHS
Arizona Department of Health Services
ADR
Adverse Drug Reaction
ADT
Admissions, Discharges, and Transfer
AEC
Annual Enrollment Choice
AEIC
Advance Earned Income Credit
AFDC
Aid For Families with Dependent Children: A federal assistance program under Title IV-A of the Social Security Act. Replaced by the Temporary Assistance to Needy Families (TANF) program.
AG
Attorney General
AGO
Arizona Governor’s Office
AHCCCS
Arizona Health Care Cost Containment System
AI
American Indian
AI/AN or AIAN
American Indian/Alaskan Native
AIHP
American Indian Health Program
AIMH
American Indian Medical Home
AIR
All-Inclusive Rate (also called OMB Rate)
AKA
Also Known As
ALTCS
Arizona Long Term Care System: The Arizona Long Term Care System), an AHCCCS program that provides long term services and supports, acute and behavioral health care services to eligible members, as authorized by ARS § 36-2931 et seq., encompassing long term care and alternative service delivery for AHCCCS members who are elderly or who have developmental or physical
disabilities.
AMADC
Automated Medical Assessment Date Capture
AMPM
AHCCCS Medical Policy Manual
AN
Alaska Native
AP
Assistance Payments
APIS
Assistance Payment Information System
APS
Adult Protective Services
APTC
Advanced Premium Tax Credit
ARHQ
Agency for Research and Healthcare Quality
ARMS
Arizona Random Moment Sampling
ARP
American Rescue Plan
ARRA
American Recovery and Reinvestment Act
ARS
Arizona Revised Statutes
ASAM
American Society of Addiction Medicine
ASH
Arizona State Hospital
ASR
Appropriations Status Report
AZBBHE
Arizona Board of Behavioral Health Examiners
AZTECS
Arizona Technical Eligibility Computer System: A computer system designed for DES to track eligibility for eligible recipients.
B
BAA
1) Business Associates Addendum
2) Business Associates Agreement
BBA
Balanced Budget Act of 1997
BCCTP
Breast and Cervical Cancer Treatment Program
BEER
Beneficiary Earnings Exchange Record
BENDEX
Beneficiary and Earnings Data Exchange is a tape source from SSA, identifying Medicare Part A and B beneficiaries.
BHRF
Behavioral Health Residential Facility
BHS
Behavioral Health Services
BIA/GA
Bureau of Indian Affairs, General Assistance
BIA
U.S. Bureau of Indian Affairs
BIC
Beneficiary Identification Code
BMS
Bureau of Member Services
BW
Base Wage
C
CAH
Critical Access Hospital
CAN
Claim Account Number
CCTS
Client Contact Tracking System
CDC
U.S. Centers for Disease Control and Prevention
CDIB or CIB
Certificate of Degree of Indian Blood
CFR
Code of Federal Regulations
CHEP
Cuban Haitian Entrant Program
CHILDS
Children's Information Library Data Source
CHIP
Children's Health Insurance Program (KidsCare)
CHIPRA
Children's Health Insurance Program Reauthorization Act
CHR
Community Health Representative
CHS
Contract Health Services
CHW
Community Health Worker
CLRS
Closed-Loop Referral System
CMDP
Comprehensive Medical and Dental Program
CMS
Center for Medicare and Medicaid Services, a federal agency under the Department of Health and Human Services
CMV
Current Market Value
CO
Central Office
COBA
Coordination of Benefits Agreement
COE
1) Court Ordered Evaluation is when a judge orders a person to receive a psychiatric evaluation.
2) Cost of Employment
COLA
Cost of Living Adjustment
COOP
Continuity of Operations Plan
COT
Court Ordered Treatment
CPT
Current Procedural Terminology. All of the codes are numerical only except for Category II and Category II codes. This is the anesthesia, surgery, radiology, laboratory and medicine codes.
CRIT
Colorado River Indian Tribes
CRS
Children's Rehabilitative Services
CSMIA
Community Spouse Monthly Income Allowance
CSRA
Community Spouse Resource Assessment
CSRD
Community Spouse Resource Deduction
CSV
Cash Surrender Value
CY
Calendar Year (defined as January 1 – December 31)
CYE
Contract Year Ending (defined as October 1 – September 30)
D
DAC
Disabled Adult/Children
DAP
Differential Adjusted Payment
DBF
AHCCCS Division of Business and Finance
DBME
Division of Benefits and Medical Eligibility (a division within the Department of Economic Security)
DCAIR
AHCCCS Division of Community Advocacy and Intergovernmental Relations
DCS
Department of Child Safety (a state agency)
DCSS
Division of Child Support Services (a division within the Department of Economic Security)
DCW
Direct Care Worker
DD
Developmental Disablilities
DDD
Division of Developmental Disabilities (a division with the Department of Economic Security)
DDSA
Disability Determination Services Administration (a division within the Department of Economic Security)
DES
Department of Economic Security
Detail
Detail ICD-10 codes are codes that are expanded to the most appropriate level of specificity and are valid for coding for the year specified.
DFSM
AHCCCS Division of Fee for Service Management
DGI
AHCCCS Division of Grants and Innovation
DHCS
AHCCCS Division of Health Care Services
DHS
Department of Health Services
DIB
Disability Insurance Benefits
DME
Durable Medical Equipment
DMPS
AHCCCS Division of Member and Provider Services
DNB
Deemed Newborn
DO
Physician Osteopath
DOA
Department of Administration
DRA
Deficit Reduction Act of 2005
DRG
Diagnostic Related Group
DSNP
Dual Special Needs Plan is a health care plan for people who have both Medicaid and
Medicare coverage.
DTO
Danger to Others is a clinical diagnosis that someone may cause harm to others.
DTS
Danger to Self is a clinical diagnosis that someone may cause harm to themselves.
Explanation of Benefits: A statement from
the insurance carrier explaining payment of claims, benefits, deductibles, copayment
responsibilities, and reasons for noncoverage of claims.
EOM
End of Month
EOMB
Executive Office of Management and Budget
EPD
Elderly and Physically Disabled
ePIP
Electronic Provider Incentive Payment
EPSDT
Early and Periodic Screening Diagnosis and Treatment
EQRO
External Quality Review Organizations
ER
Emergency Room
ERA
Electronic Remittance Advice
ESRD
End Stage Renal Disease
EVV
Electronic Visit Verification
EW
Eligibility Worker
EY
End of Year
F
FAA
Family Assistance Administration (an administration under DES/DBME)
FBR
Federal Benefit Rate
FC
Foster Care
FDIH
Fort Defiance Indian Hospital
FEHBA
Federal Employees Health Benefit Act of 1959
FES
Federal Emergency Services
FESP
Federal Emergency Services Program
FFP
Federal Financial Participation
FFS
Fee-For-Service
FFY
Federal Fiscal Year (defined as October 1 – September 30)
FIC
Family Involvement Center is a not-for-profit, family-directed organization that assists and supports families/caregivers with children experiencing emotional, behavioral, or mental health disorders.
FWA
Fraud, Waste and Abuse
FMV
Fair Market Value
FOLD
FAA On-Line Documents
FPL
Federal Poverty Limit
FPS
Family Planning Services
FQHC
Federally Qualified Healthcare Centers
FTP
File Transport Protocol
FTW
Freedom to Work
G
GA
General Assistance
GEP
General Enrollment Period
GIMC
Gallup Indian Medical Center
GMH
General Mental Health is a classification of diagnoses that is not Seriously Mentally Ill; these diagnoses are not so severe that people cannot function without intense services and medication(s).
GMHSU
General Mental Health/Substance Use (formerly GMHSA, or General Mental Health/Substance Abuse)
GRHCC
Gila River Health Care Corporation (dba Hu Hu Kam Hospital)
GSA
Geographic Service Area
GSL
Guaranteed Student Loan
GUIDE
General Unemployment Insurance Development Effort (the system that maintains Arizona Unemployment data)
H
Header
Header ICD-10 codes require more digits to indicate the appropriate level of specificity. ICD-10 codes that were once detailed and then expanded for more detail then turn into header codes. These code sets are not valid for coding purposes.
HCBS
Home and Community Based Services
HCE
Health Care Excel Quality Quest, Inc.
HCPCS
Healthcare Common Procedure Coding System. These codes are for transportation; outpatient, drugs, DME, orthotic and prosthetic codes and they all start with a letter from the alphabet.
HEAplus
Health-e-Arizona Plus
HEALTHII
Hospital Enhanced Access Leading to Health Improvement Initiative
HEDIS
Healthcare Effectiveness Data and Information Set
HHCC
Hopi Health Care Center
HHS
U.S. Department of Health and Human Services
HI
Hospital Insurance
HIC
Health Insurance Claim Number
HIE
Health Information Exchange
HIFA
Health Insurance Flexibility and Accountability Act
HIPAA
Health Insurance Portability and Accountability Act of 1996
HIT
Health Information Technology
HMS
Health Management Systems
HN/HC
High Needs/High Cost
HP
Health Plan
HPE
Hospital Presumptive Eligibility
HRSN
Health-Related Social Needs
HSAG
Health Services Advisory Group, Inc.
HUD
Housing and Urban Development
I
IC
Industrial Commission
ICD-9-CM
International Classification of Diseases, 9th revision. These are the diagnosis codes that are used.
ICD-9 Vol 3
International Classification of Diseases, 9th revision for Procedures performed as inpatient surgery
ICD-10
International Classification of Diseases, 10th Revision
ICD-10-CM
International Classification of Diseases, 10th revision. These diagnosis codes replaced the ICD-9-CM codes as of 10/01/2015
ICD-10-PCS
International Classification of Diseases, 10th revision. These surgery procedure codes replaced the ICD-9 volume 3 as of 10/01/2015
IEP
Initial Enrollment Period
IFB
Invitation for Bid
IGA
Intergovernmental Agreement
IHCIA
Indian Health Care Improvement Act of 1976
IHS
U.S. Indian Health Service
IMD
Institution for Mental Disease
INS
Immigration and Naturalization Service
IOT
Income Only Trust
IP
In-patient
IPV
Intentional Program Violation
IRS
Internal Revenue Service
IRWE
Impairment Related Work Expense
ISA
1) Interstate Agreement
2) Interagency Service Agreement
ISD
AHCCCS Information Services Division
ISM
In-kind Support and Maintenance
ISP
Individualized Service Plan is a plan that a person receiving behavioral health services develops with his/her case manager to outline his/her treatment goals and methods to achieve those goals.
ITCA
Inter Tribal Council of Arizona, Inc.
ITU or I/T/U
Indian Health Service, Tribally Operated 638 Facilities, Urban Indian Health Clinics
IV-A
Refers to programs under Title IV-A of the Social Security Act (example: Cash Assistance/Temporary Assistance to Needy Families (TANF))
IV-D
Refers to programs under Title IV-D of the Social Security Act (example: Child/medical Support and Establishment of Paternity)
IV-E
Refers to programs under Title IV-E of the Social Security Act (example: Foster Care and Adoption Subsidy)
IVR
Interactive Voice Response
J
JOBS
Job Opportunities and Basic Skills Program
JTPA
Job Training Partnership Act
K
KC
KidsCare
L
LEP
Limited English Proficiency
LIC-FAC
Licensed Facility
LIEAP
Low Income Energy Assistance Program
LPG
Legal Permanent Guardian
LPR
Lawful Permanent Resident
LTC
Long Term Care
M
M/C
Medicare Claim Number
MA
Medical Assistance
MAGI
Modified Adjusted Gross Income
MAO
Medical Assistance Only
MAT
Medication-Assisted Treatment
MCO
Managed Care Organization
MCR
Member Change Report
MD
Medical Doctor/Physician
MCU
Medical Coding Unit, this unit is the sole entity that makes sure all codes, whether new or old or changed, are added to PMMIS. Also, they provide support to help Providers and Health Plans in their coding issues.
MEDICS
Medical Eligibility Determination and Information Control System
MHA
Mental Health of America, a non-profit organization that advocates for those diagnosed
with a mental illness.
MHFA
Mental Health First Aid
MI/MN
Medically Indigent/Medically Needy
MIKID
Mentally Ill Kids in Distress is a service provider that provides support and assistance to families in Arizona with behaviorally challenged children, youth and young adults.
MMA
Medicare Prescription Drug Improvement and Modernization Act of 2003
MMMNA
Minimum Monthly Maintenance Needs Allowance
MOA
Memorandum of Agreement
MOU
Memorandum of Understanding
MOUD
Medications for Opioid Use Disorders
MSBC
Medicaid School Based Claiming
MSIC
Multi-Specialty Interdisciplinary Clinic
MSP
Medicare Savings Program
MSN
Monthly Spousal Need
N
N/A
Not Applicable
NA
1) Native American
2) Nutrition Assistance Program (formerly known as Food Stamps)
NAC
Native American Connections
NACA
Native Americans for Community Action, Inc.
NACHCI
Native American Community Health Center, Inc. (dba Native Health)
NAIHS
Navajo Area Indian Health Service
NAMI
National Alliance on Mental Illness is a non-profit advocacy group for those receiving behavioral health services and their families.
NAO
Navajo Area IHS Office
NB
Newborn
NCCI
National Correct Coding Initiative
NCHICA
North Carolina Healthcare Information and Communications Alliance
NCPDP
National Council for Prescription Drugs Programs
NCQA
National Committee for Quality Assurance
NCR
No Carbon Required
NCUIH
National Council of Urban Indian Health
NCVHS
National Committee on Vital and Health Statistics
NEMT
Non-Emergency Medical Transportation
NEW
Native Employment Works
NF
Nursing Facility
NICOA
National Indian Council on Aging
NIH
National Institutes of Health
NIHB
National Indian Health Board
NOA
Notice of Action
NOAA
Notice of Adverse Action
NOH
Notice of Hearing
NP
Nurse Practitioner
NPI
National Provider Identification Number
NPPES
National Plan and Provider Enumeration System
NUBC
National Uniform Billing Committee
O
OAH
Office of Administrative Hearings
OALS
Office of Administrative Legal Services
OASDI
Old Age Survivor Disability Income
OCE
Outpatient Claim Editor
OCR
Optical Character Recognition
OHR
Office of Human Rights
OIG
Office of Inspector General
OJT
On the Job Training
OMB
Office of Management and Budget (used in phrase OMB Rate; see AIR)
OMH
U.S. Office of Minority Health
OOD
Office of the Director
OP
Outpatient
OPFS
Outpatient Hospital Fee Schedule
OPPS
Outpatient Prospective Payment System
P
PA
Prior Authorization
PACeHR
Purchasing & Assistance Collaborative for Electronic Health Records
PAIHS
Phoenix Area Indian Health Service
PAO
Phoenix Area IHS Office
PAS
Pre-Admission Screening
PASRR
Pre-Admission Screening and Resident Review
PAT
Provider Affiliation Transmission
PATH
Project for Assistance to Transition from Homelessness
PBC
Patient Benefits Coordinators
PBM
Pharmacy Benefit Manager
PBO
Patient Business Office; or possibly Public Benefits Outreach (ITCA program)
PC
Program Contractor
PCCR
Program Contractor Change Request
PC
Prescribing Clinician is a member of a clinic team that has the authority to prescribe medications.
PCP
Primary Care Physician is a doctor that provides general medical care.
PCSP
Person Centered Service Plan
PDP
Prescription Drug Plan
PERM
Payment Error Rate Measurement
PCSP
Person Centered Service Plan
PHI
Protected Health Information
PHS
Public Health Service
PI
Primary Informant
PIC
Phoenix Indian Center, Inc.
PIMC
Phoenix Indian Medical Center
PIO
Public Information Officer
PIP
1) Practice Improvement Protocol is a set of guidelines and best practices established by ADHS/DBHS for clinicians to follow to ensure proper behavioral health services are provided.
2) Performance Improvement Project(s)
PMMIS
Pre-paid Medical Management Information System
PMV
Presumed Maximum Value
PNA
Personal Needs Allowance
PPACA
Patient Protection and Affordable Care Act
PSE
Program Services Evaluator
PQ
Prior Quarter
Q
QI
Qualified Individual; or possibly Quality Improvement
QI-1
Qualified Individual-1
QM/UM
Quality Management/Utilization Management
QMB
Qualified Medicare Beneficiary
QOC or QOCC
Quality of Care Concern
R
RBHA
Regional Behavioral Health Agreement
RCA
Refugee Cash Assistance
RFH
Request for Hearing
RFI
Request for Information
RFP
Request for Proposal
RFQ
Request for a Quote
RN
Registered Nurse
RPMS
Resource and Patient Management System
RR
Railroad Retirement
RRB
Railroad Retirement Benefits
RRP
Refugee Resettlement Program
RSA
Rehabilitation Services Administration
RSDI
Retirement Survivor’s Disability Insurance
RTC
Residential Treatment Center
S
SABG
Substance Abuse Block Grant
SAIL
Senior Adult Independent Living
SAMHSA
U.S. Substance Abuse and Mental Health Services Administration
SAVE
Systematic Alien Verification for Entitlements
SCHIP
State Children's Health Insurance Program (KidsCare)
SCORE
Service Core of Retired Executive
SDOH
Social Determinants of Health
SED
Serious Emotional Disturbance
SEOP
Supplementary Education Opportunity Grants
SEP
Special Enrollment Period
SESP
State Emergency Services Program
SFY
State Fiscal Year (defined as July 1 – June 30)
SGA
Substantial Gainful Activity
SHARE
Service to Help Arizonan's with Relief on Energy
SHIP
State Health Insurance Assistance Program
SLMB
Specified Low-Income Medicare Beneficiary
SMI
1) Serious Mental Illness
2) Seriously Mentally Ill is a diagnosis that means the illness is disabling and requires intense behavioral health services and medication(s).
SMIB
Supplemental Medical Insurance Benefit
SNAP
Supplemental Nutrition Assistance Program (previously known as Food Stamps)
SNF
Skilled Nursing Facility
SNIP
Strategic National Implementation Process
SOBRA
Sixth Omnibus Budget Reconciliation Act
SOC
Share of Cost
SOLQI
State On-Line Query Internet
SOTA
State Opioid Treatment Authority
SPA
State Plan Amendment
SS-5
Application for a Social Security Number
SSA
1) Social Security Act is the federal government act that mandates Title 19 and Title 21 benefits.
2) U.S. Social Security Administration
SSD
Social Security Disability
SSDI
Social Security Disability Insurance
SSI
Supplemental Security Income
SSI MAO
Supplemental Security Income Medical Assistance Only
SSIG
State Student Incentive Grants
SSN
Social Security Number
SSR
Social Security Retirement
STT
Special Treatment Trusts
SU
1) Service Unit
2) Substance Use is the use of illegal substances like illegal drugs and prescription drugs; it also includes using substances in ways other than intended like gasoline, household chemicals, etc.
SUA
Standard Utility Allowance
Subcategory
The breakdown of a category if there are several parts that have their own codes.
SUD
Substance Use Disorder
SVES
State Verification and Exchange System
T
T1
First Extension (Transitional Medical Assistance)
T2
Second Extension (Transitional Medical Assistance)
T3
Third Extension (Transitional Medical Assistance)
T4
Fourth Extension (Transitional Medical Assistance)
TAIHS
Tucson Area Indian Health Service
TANF
Temporary Assistance for Needy Families
TAO
Tucson Area IHS Office
TC
Tuberculosis Control
TCRHCC
Tuba City Regional Health Care Corporation
TCS
Transactions and Code Sets
TI
Targeted Investments Program
TIC
Tucson Indian Center, Inc.
TIG
Technical Interface Guidelines
TITLE XIX
The section of the Social Security Act which describes the Medicaid program's coverage for eligible persons, (i.e., medically indigent).
Title 19 benefits are provided through the Medicaid federal entitlement program; benefits are delivered in Arizona through the Arizona Health Care Cost Containment System.
TITLE XVI
The section of the Social Security Act that provides eligibility requirements for the SSI Cash program.
TITLE XVIII
The section of Social Security Act that describes the Federal Medicare program's coverage for eligible persons (i.e., aged, blind and disabled).
TITLE XX
An amendment to the Social Security Act that requires the establishment of a comprehensive plan and the coordination of social services through community involvement.
TITLE XXI
The section (or Title) of the Social Security Act that authorizes the State Children's Health Insurance Program known as KidsCare in Arizona
TITLE XXI/T21
Title 21 benefits are a separate benefits program funded by federal dollars; in Arizona, this program is provided through AHCCCS and is known more commonly as KidsCare.
TMA
Transitional Medical Assistance
TOPS
Technical Operations Production Support
TPEP
Two Parent Employment Program
TPL
Third-Party Liability
TRBHA
Tribal Regional Behavioral Health Authority
TRE
Training Related Expenses
TRL
Tribal Relations Liaison
TTAG
Tribal Technical Advisory Group (to the Centers for Medicare and Medicaid Services)
TWEP
Tribal Work Experience Program
U
UB
Uniform Billing
UI
Unemployment Insurance
UIHP
Urban Indian Health Program
Unit Parameters
The specific requirements for each code such as to whether the code is a covered benefit for a specific population serviced, age & sex limits, frequency limits (day, month, year, lifetime, etc.), Medicare coverage, appropriate modifiers, service provider types, place of service, CLIA coverage, family planning, abortion, sterilization, and other as necessary
UP
Unemployed Parents
UPC
Urgent Psychiatric Care is a facility that provides behavioral health care to those in crisis for no more than 23 hours, after which they are referred to another inpatient or outpatient service provider.
UR
Utilization Review
USC
United States Code
USCIS
United States Citizenship and Immigration Services (part of Homeland Security)
