AHA Coding Clinic® for HCPCS - 2001 Issue 4; FOR your INFORMATION
Reminder
Cost reimbursement payments may not be made to the hospital outpatient departments for any items or services, while processing claims of bill types 12X, 13X, and 14X, except for: Corneal tissue; and Ambulance services. Under OPPS, payment on a cost reimbursement basis no longer applies, with the exception of those items previously listed. ...
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Article Overview
This short Find-A-Code reminder explains a Medicare outpatient payment policy update affecting hospital outpatient departments and claim processing for specific bill types. It is relevant to hospital billing staff, coders, and revenue cycle teams who need to understand the general scope of the payment limitation and the narrow exceptions that remain.
Why This Topic Matters
It helps readers quickly identify a policy reminder that may affect outpatient claim payment handling and whether a hospital’s billing workflow is impacted.
What You Will Learn
- The general outpatient payment context addressed by the reminder
- Which hospital outpatient claim types are referenced
- The broad categories of items and services treated as exceptions
- How the reminder relates to OPPS reimbursement policy
Who Should Read This
- Hospital outpatient coders
- Hospital billing staff
- Revenue cycle teams
- Compliance staff
Code Ranges Discussed
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