AHA Coding Clinic® for HCPCS - 2001 Issue 4; FOR your INFORMATION

Claims resulting in no APC payments

If the claim contains only services payable under cost reimbursement, such as ambulance, and services that would be packaged services that would be packaged services if an APC were payable, then the packaged services are not separately payable. In addition, these charges for the packaged services are not use to calculate TOPs. If the claim contains only services payable under a fee schedule, such as clinical diagnostic laboratory, and also contains services that would be packaged services if an APC were payable, the packaged services are not separately payable. In addition, the charges are not used to calculate TOPs...

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