tci ED Coding & Reimbursement Alert - 2000 Issue 7

Reader Questions: Billing Nurse Services Under APCs

Question: We would like to know if we will need to bill for nurses services separately under the new APC guidelines. The hospital currently does not bill fee-for-service, but the doctors do. How do these new regulations affect our procedure coding and encounter form?Alabama SubscriberAnswer: Ambulatory Payment Classifications (APCs) only apply to the facility component of the patients visit. As such, nursing services are included in the APC that will be assigned by the Health Care Financing Administration (HCFA). The hospital must code a facility service level using the HCPCS codes and submit that on the UB-92. The...

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