AHA Coding Clinic® for HCPCS - 2013 Issue 4

Hospital outpatient clinic and emergency department visits under the OPPS

Hospitals are currently functioning under a longstanding policy established April 7, 2000, by the Centers for Medicare & Medicaid Services (CMS) which states that because a national set of hospital-specific codes and guidelines do not currently exist for the reporting of clinic and emergency department (ED) visits hospitals were instructed to develop internal guidelines for reporting the appropriate visit level of service. In the calendar year (CY) 2014 update, Medicare modified its hospital outpatient clinic visit policy. Information regarding this modified policy can be found in the CY 2014 OPPS/ASC final rule that was published in the Federal Register...

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