31 results.
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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....
Comparison of the Prospective Payment System Methodologies in the United States
Author: Cade, Toni
Source: AHIMA Convention
Publication Date: October 15, 2004
Overview
Currently, there are many different prospective payment systems in the US for reimbursement of healthcare services. Each of these systems is unique and complex, and the various healthcare providers are challenged to understand their application. Reimbursement is based up....
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....
Hospital Outpatient Prospective Payment System Updated for 2014
Author: Comfort, Angie
Source: Journal of AHIMA - Coding Notes
Publication Date: March 2014
With only a few weeks left in 2013, the Hospital Outpatient Prospective Payment System (OPPS) final rule for calendar year (CY) 2014 was released on November 27, 2013 and went into effect on January 1, 2014. The final rule is normally provided to the public around the first week of Novemb....
Internal Auditing Techniques for Ambulatory Payment Classification (APC) Revenue Integrity
Author: Clark, Andrea
Source: AHIMA Convention
Publication Date: October 15, 2004
Presentation Overview
In order to achieve reimbursement integrity under Ambulatory Payment Classifications (APCs), internal auditing is imperative. We will examine some of the top procedures and services performed in Ambulatory Surgery (AS), the Emergency Department (ED), and the Ancilla....
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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