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M
Manual Processing Strategies
Relate to recovery procedures that do not rely on the computerized application(s) associated with critical functions. Using manual workarounds, critical functions or portions of a critical function can continue to be processed.
Local Code(s)
A generic term for code values that are defined for a state or other political subdivision, or for a specific payer. This term is most commonly used to describe HCPCS Level III Codes, but also applies to state-assigned Institutional Revenue Codes, Condition Codes, Occurrence Codes, Value Codes, etc.
Logical Observation Identifiers, Names and Codes (LOINC_)
A set of universal names and ID codes that identify laboratory and clinical observations. These codes, which are maintained by the Regenstrief Institute, are expected to be used in the HIPAA claim attachments standard.
Loop
A repeating structure or process.
LTC
Long-Term Care.
M+CO
Medicare Plus Choice Healthcare organization.
Massachusetts Health Data Consortium (MHDC)
A healthcare organization that seeks to improve healthcare in New England through improved policy development, better technology planning and implementation, and more informed financial decision making.
Maximum Defined Data Set
Under HIPAA, this is all of the required data elements for a particular standard based on a specific implementation specification. An entity creating a transaction is free to include whatever data any receiver might want or need. The recipient is free to ignore any portion of the data that is not needed to conduct their part of the associated business transaction, unless the inessential data is needed for coordination of benefits.
MCO
Managed Care Healthcare organization.
Medicaid Fiscal Agent (FA)
The healthcare organization responsible for administering claims for a state Medicaid program.
Medicaid State Agency
The state agency responsible for overseeing the state's Medicaid program.
Medical Code Sets
Codes that characterize a medical condition or treatment. These code sets are usually maintained by professional societies and public health healthcare organizations. Compare to administrative code sets.
Medical Records Institute (MRI)
A healthcare organization that promotes the development and acceptance of electronic health care record systems.
Medicare Contractor
A Medicare Part A Fiscal Intermediary, a Medicare Part B Carrier, or a Medicare Durable Medical Equipment Regional Carrier (DMERC).
Medicare Durable Medical Equipment Regional Carrier (DMERC)
A Medicare contractor responsible for administering Durable Medical Equipment (DME) benefits for a region.
Medicare Part A Fiscal Intermediary (FI)
A Medicare contractor that administers the Medicare Part A (institutional) benefits for a given region.
Medicare Part B Carrier
A Medicare contractor that administers the Medicare Part B (Professional) benefits for a given region.
Medicare Remittance Advice Remark Codes
A national administrative code set for providing either claim-level or service-level Medicare-related messages that cannot be expressed with a Claim Adjustment Reason Code. This code set is used in the X12 835 Claim Payment & Remittance Advice transaction, and is maintained by the HCFA.
Memorandum of Understanding (MOU)
A document providing a general description of the responsibilities that are to be assumed by two or more parties in their pursuit of some goal(s). More specific information may be provided in an associated SOW.
MGMA
Medical Group Management Association.
Minimum Scope of Disclosure
The principle that, to the extent practical, individually identifiable health information should only be disclosed to the extent needed to support the purpose of the disclosure.
Minnesota Health Data Institute (MHDI)
A public/private partnership for improving the quality and efficiency of heath care in Minnesota. MHDI includes the Minnesota Center for Healthcare Electronic Commerce (MCHEC), which supports the adoption of standards for electronic commerce and also supports the Minnesota EDI Healthcare Users Group (MEHUG).
Mobile Recovery
A mobilized resource purchased or contracted for the purpose of business recovery. The mobile recovery center might include: computers, workstations, telephone, electrical power, etc.
MODEM (Modulator Demodulator Unit)
A device that converts data communications analog signals to digital signals and back again.
Modify or Modification
Under HIPAA, this is a change adopted by the Secretary, through regulation, to a standard or an implementation specification.
MR
Medical Review.
MSP
Medicare Secondary Payer.
