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Coding for APCs: Case Studies

Author: Scichilone, Rita A

Source: Journal of AHIMA - Coding Notes

Publication Date: July 2000


When APC implementation begins on August 1, HIM professionals can expect increased complexity when coding outpatient encounters. Examining case studies in selected areas subject to APC payment may help coding professionals better understand the APC reporting process. Although coding guidelines....

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....

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....

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....

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....

Key Issues in the 2008 OPPS Final Rule

Author: Clark, Andrea

Source: Journal of AHIMA

Publication Date: March 2008



The main objective of the Centers for Medicare and Medicaid Services (CMS) implementation of the 2008 Outpatient Prospective Payment System (OPPS) final rule was to address the recent explosion of growth in program expenditures for hospital outpatient services. CMS has created additional i....

Key Issues in the 2009 OPPS Final Rule

Author: Clark, Andrea

Source: Journal of AHIMA - Coding Notes

Publication Date: March 2009


The final rule for the 2009 Outpatient Prospective Payment System (OPPS) includes multiple revisions that hospitals must address in their practices, policies, and operations. Hospitals should develop strategies for analyzing the financial impact and operational challenges by reviewing the foll....

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