OPPS 2014: Revise Your Reporting Strategy To Deal With These OPPS Changes in 2014

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article reviews selected changes in the 2014 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) payment rule. It is aimed at hospital outpatient coding, billing, and reimbursement professionals who need a high-level view of how CMS revised packaged service categories, outpatient clinic visit reporting, and related payment updates for 2014.

Why This Topic Matters

The changes discussed affect how outpatient hospital services are reported and how payment is structured under Medicare. Understanding the scope of the final rule helps facilities assess reporting workflows and payment-impacting policy updates.

Article Sections

  1. Pay Attention to Updated Packaged Service Categories

    Discusses CMS packaging changes in the OPPS final rule and the broad categories of services affected. It also explains the general reporting context for packaged items and services under hospital outpatient claims.

  2. Narrow Outpatient Clinic Visit Options to One

    Covers the consolidation of outpatient clinic visit reporting under the 2014 final rule and its relationship to APC assignment and status indicator changes. The section also notes related context for emergency department visit reporting.

  3. Watch for Bottom-Line Changes

    Summarizes the 2014 payment update context, including market basket adjustments and timing information for the final rule. It also references the rule’s publication and implementation timeframe.

What You Will Learn

  • Which broad OPPS and ASC policy areas changed for 2014
  • How CMS approached packaging of outpatient services
  • How outpatient clinic visit reporting was revised under the final rule
  • What payment update changes were announced for CY 2014
  • When the final rule was published and implemented

Who Should Read This

  • Hospital outpatient coders
  • Outpatient billing staff
  • Revenue cycle professionals
  • Compliance and reimbursement teams
  • ASC and hospital payment policy readers

Codes Discussed

  • HCPCS: G0463
  • CPT: 99201-99215

Code Ranges Discussed

  • CPT: 99201-99215

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