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Getting Ready for APCs

Author: Scichilone, Rita A

Source: Journal of AHIMA

Publication Date: September 1999


While most healthcare practitioners support accurate coding, the challenge remains for HIM professionals: how to achieve coding accuracy in a system of imperfect data capture methods and changing reimbursement methodologies. Greater emphasis on coding specificity and completeness for reimburs....

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....

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....

CY 2011 Changes to the Hospital OPPS

Author: Karban, Karen M

Source: Journal of AHIMA - Coding Notes

Publication Date: April 2011


The final rule for the calendar year 2011 Hospital Outpatient Prospective Payment System (OPPS) was released November 24, 2010. Changes in the rule went into effect with January 1, 2011, outpatient hospital-based services.

The changes to OPPS continue to reflect packaging adjustments....

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....

CY 2017 OPPS Update

Author: Comfort, Angie

Source: Journal of AHIMA - Coding Notes | Journal of AHIMA

Publication Date: February 2017



As last year drew to a close, facilities began the looming task of reviewing the Hospital Outpatient Prospective Payment System (OPPS) final rule to ensure their chargemaster and systems were up-to-date with the 2017 changes. The final rule for calendar year (CY) 2017 was released on Novem....

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