Glossary

Manu Murugesan edited this page Mar 14, 2026 · 4 revisions

CMS terminology, acronyms, and column name conventions used throughout medicaid-utils.

Acronyms

Acronym	Full Name
CMS	Centers for Medicare & Medicaid Services
MAX	Medicaid Analytic eXtract (pre-2016 file format)
TAF	T-MSIS Analytic Files (2016+ file format)
T-MSIS	Transformed Medicaid Statistical Information System
ICD-9	International Classification of Diseases, 9th Revision
ICD-10	International Classification of Diseases, 10th Revision
CPT	Current Procedural Terminology
HCPCS	Healthcare Common Procedure Coding System
NDC	National Drug Code
NPI	National Provider Identifier
FQHC	Federally Qualified Health Center
FFS	Fee-For-Service
RUCA	Rural-Urban Commuting Area
RUCC	Rural-Urban Continuum Code
PCSA	Primary Care Service Area
ZCTA	ZIP Code Tabulation Area
PQI	Prevention Quality Indicator
BETOS	Berenson-Eggers Type of Service
CDPS	Chronic Illness and Disability Payment System
PMCA	Pediatric Medical Complexity Algorithm
OUD	Opioid Use Disorder
MAT	Medication-Assisted Treatment
HCRIS	Healthcare Cost Report Information System
UDS	Uniform Data System
ResDAC	Research Data Assistance Center

Column	Description
`MSIS_ID`	State-assigned beneficiary ID (unique within state and year)
`DIAG_CD_1` – `DIAG_CD_9`	Diagnosis codes
`PRCDR_CD_1` – `PRCDR_CD_6`	Procedure codes
`PRCDR_CD_SYS_1` – `PRCDR_CD_SYS_6`	Procedure coding system (1=CPT, 6=ICD-9, 7=ICD-10-PCS)
`SRVC_BGN_DT`, `SRVC_END_DT`	Service begin/end dates
`ADMSN_DT`, `DSCHRG_DT`	Admission/discharge dates (IP)
`RCPNT_DLVRY_CD`	Delivery recipient code
`PLC_OF_SRVC_CD`	Place of service code
`EL_RSDNC_ZIP_CD_LTST`	Beneficiary ZIP code (PS)

Column	Description
`BENE_MSIS`	Composite beneficiary ID constructed by medicaid-utils: `STATE_CD-HAS_BENE-(BENE_ID or MSIS_ID)`
`DGNS_CD_1` – `DGNS_CD_12`	Diagnosis codes
`ADMTG_DGNS_CD`	Admitting diagnosis
`PRCDR_CD_1` – `PRCDR_CD_6`	Procedure codes
`LINE_PRCDR_CD`	Line-level procedure code
`SRVC_BGN_DT`, `SRVC_END_DT`	Service begin/end dates
`NDC`	National Drug Code (pharmacy claims)
`DAYS_SUPPLY`	Prescription days of supply
`BENE_ZIP_CD`	Beneficiary ZIP code (DE)

Column	Description
`LST_DIAG_CD`	Comma-separated list of all diagnosis codes per beneficiary. MAX: must be constructed from `DIAG_CD_*` columns. TAF: created by `gather_bene_level_diag_ndc_codes()` on `dct_files["base_diag_codes"]`
`LST_NDC`	Comma-separated list of all NDC codes per beneficiary. TAF: created by `gather_bene_level_diag_ndc_codes()` on `dct_files["line_ndc_codes"]`
`ed_use`	1 if claim is an ED visit (any criterion)
`ed_cpt`	1 if ED identified via CPT codes (99281–99285)
`ed_ub92`	1 if ED identified via UB-92 revenue codes
`ed_tos`	1 if ED identified via Type of Service
`ed_pos`	1 if ED identified via Place of Service
`excl_missing_dob`	1 if date of birth is missing (used as exclusion filter)
`excl_duplicated`	1 if claim is a duplicate (used as exclusion filter)

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