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E/M Options in the Outpatient Arena

Author: Jones, Lolita M.

Source: Journal of AHIMA

Publication Date: July 2001

Under the Medicare ambulatory payment classification (APC) system, hospitals must establish criteria for mapping the medical care rendered in the emergency department and hospital-based outpatient settings to appropriate CPT medical visit codes. Do you know how to establish a sound rationale f....

Know Your APCs: Data Analysis Made Simple

Author: Stegman, Melinda

Source: Journal of AHIMA

Publication Date: July 2001

You’ve adapted processes to the APC system, but do you really understand the financial impact of APCs on your organization? The author shows you how to analyze your billing data to assess the impact of APCs on your facility’s bottom line.

Since the implement....

APC Validation Audits ... The Nitty Gritty Details

Author: Knowles, Lisa

Source: AHIMA Convention

Publication Date: October 10, 2001

Ambulatory payment classifications (APCs) have been implemented, and APC validation audits are the next issue to contend with. Similar to DRGs, we must design and conduct APC validation audits. Whether the audit is performed in-house or by an external consulting firm, it is essential....

APCs: A Hospital-wide Effort

Author: Neilson, Seana

Source: AHIMA Convention

Publication Date: October 10, 2001

For many healthcare providers, thriving under the Medicare outpatient prospective payment system (i.e., APCs) appears to be a distant goal not to be realized anytime soon. In fact, for the next year or so, most healthcare providers subject to APCs will most likely be satisfied with me....


Author: AHIMA Coding Team

Source: AHIMA Q and A

Publication Date: October 2002

Where can I find the APC regulations?

The HCFA regulations are found in the November 13, 2000 Federal Register, Vol. 65. No.219 pp.67798-68005. Go to, and scroll down to Health Care Financing Administration.

HCFA has impleme....

Analysis of Final Rule for 2003 Revisions to the Medicare Hospital Outpatient Prospective Payment System

Author: AHIMA Policy and Government Relations Team

Source: AHIMA regulation analysis

Publication Date: November 24, 2002

The final rule regarding calendar year 2003 revisions to the Medicare hospital outpatient prospective payment system (PPS) was published in the November 1, 2002 issue of the Federal Register.   This rule becomes effective on January 1, 2003.   This analysis will cover significant....

Providers Join Hands to Tell Medicare What They Think about OPPS/APC Policies: Making Progress in Changing Future Rules and Regulations

Author: Shah, Jugna

Source: AHIMA Convention

Publication Date: October 15, 2004

The Provider Roundtable is the name of the group that I formed to offer an opportunity for providers to come together and communicate to Medicare about their day-to-day operational challenges under the Outpatient Prospective Payment System (OPPS). My hope was that, by engaging providers to bra....

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