AHA Coding Clinic® for HCPCS - 2004 Issue 4

CMS further defines observation care

The Centers for Medicare & Medicaid Services (CMS) defines observation care as an active treatment where determination of the patient’s condition determines whether he/she requires admission as an inpatient or if the condition will resolve itself and the patient will be discharged. Since implementation of the hospital outpatient prospective payment system (OPPS) observation services are no longer paid separately nor assigned to a separate APC. Instead, cost for the observation services are now packaged into payments for the services with which the observation care is associated. In 2002, CMS implemented separate payment for observation services provided under the...

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