tci Outpatient Facility Coding Alert - 2014 Issue 11

Coding Update: Heads Up: Some Outpatient Codes Are Ready to Bundle Up as 'Mini DRGs'

Your reporting could change drastically in 2015, thanks to comprehensive APCs including associated smaller services. In an attempt to streamline the Medicare payment system, CMS has introduced new bundled codes for outpatient services that will put the outpatient coding system in sync with inpatient diagnosis-related groups (DRGs). According to CMS’ proposed outpatient payment rule, the “comprehensive APCs” will be implemented starting Jan. 1, 2015. At present, the basic payment unit on which providers are reimbursed in Medicare’s outpatient prospective payment system is the ambulatory payment classification, or APC.  Some coding experts feel these new comprehensive bundled...

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