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Outpatient Surgery E-Weekly

Contact Congress Over Drug Shortage Issues

A Kentucky congressman is urging surgical facilities to contact their members of Congress and request that they sign his letter demanding changes to...

N.J. Posts ASC Inspection Reports Online

State and federal inspection reports of New Jersey's ASCs are now available online, giving patients an opportunity to make more informed choices abo...

Are Opioids Necessary?

While it's not always practical, or even possible, to eliminate opioids from your post-op pain management regiment, reducing their use in favor of n...

Archive > May, 2007 Vol. VIII, No. 5

Coding & Billing

The ABCs of APCs

Lolita M. Jones, RHIA, CCS

Sweeping new Medicare regulations that take effect in January will replace the nine ASC payment groups with hundreds of Ambulatory Payment Classification groups. In addition to the new APC groups, the Medicare reimbursement policies - such as covered procedures, multiple procedure discounting and implant reimbursement - will also change. You may have to undergo a significant transformation in the way you operate if you expect to operate successfully under the APC system. This article, the first in a three-part series, will analyze the impact APCs will have on your surgery center.

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APC group logic; ASC data generation; Analyzing the data; Sample Code-specific ASC Case Data Report; APC Payment System? The APC; APCs; ASC; ASC Case Data Report Account Patient Physician Carrier Bill; ASCs; Ambulatory Payment Classification; August; CMS; CPT; Case Data Report Account Patient Physician Carrier Bill; Classification; Compile; Data Report Account Patient Physician Carrier Bill; Destruction; Diagnosis Related Groups; Federal Register; Fee Schedule. Analyzing; Group; Grouping; Groups; HCPCS Level II; II; II Destruction; January; Level II; Level II Destruction; Medicare; Medicare Fee Schedule. Analyzing; Payment Classification; Payment System? The APC; Register; Related Groups; Remember; Report Account Patient Physician Carrier Bill; Schedule. Analyzing; Sweeping; System? The APC; abbreviated; actual; addition; adjusted; ambulatory; analogous; analyze; anesthesiologists; apply; assess; assigned; basis; billing; bring; capped; carpal; case; case-mix; cases; category; changing; clinical; clinically; clusters; code; code-specific; codes; comparable; compare; compensated; consult; costs; covered; data; decrease; define; denoting; department; detailed; diagnoses; diagnosis; discounting; displaying; effect; effective; encourage; entered; established; examples; excluded; expect; facility; final; form; frequency; generate; geographic; give; group; groups; high; high-frequency; high-volume; hospital; hospitals; hundreds; impact; implant; injections; inpatient; intensity; key; lesions; listed; low; method; multiple; national; nonpayment; number; operate; operations; order; outpatient; packages; page; paid; patient-specific; patterns; pay; payment; pays; perform; performing; physicians; plans; policies; population; potential; premalignant; prepare; procedure; professional; project; proposed; prospective; published; rate; receive; regulations; reimbursement; relative; release; replace; report; reported; reports; resource; review; rule; service; significant; similar; skin; software; specific; start; successfully; supplies; surgery; system; three-part; transformation; tunnel; typical; undergo; volume; ways; weight

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