Health Information Management

Don't leave money on the table: Report eligible procedures under OPPS

Briefings on Coding Compliance Strategies, February 1, 2009

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Briefings on Coding Compliance Strategies.

Effective January 1, coders can report HCPCS code C9899 when providers implant a prosthetic device for a Medicare beneficiary who is an inpatient but who doesn’t have Part A coverage of inpatient services on the date of the procedure. 

This concept—receiving reimbursement for an in- patient service under the outpatient prospective pay- ment system (OPPS)—isn’t new. In fact, there are 11 categories of inpatient Part B services that providers can bill under the OPPS. However, the recent guidance from CMS about HCPCS code C9899 offers a good reminder of financial opportunities that your hospital might be missing. 

Many providers are unaware that they can receive reimbursement for certain categories of inpatient ser-vices under the OPPS, says Kimberly Anderwood Hoy, JD, CPC, director of Medicare and compliance at HCPro, Inc., in Marblehead, MA. Just as with any type of compliant coding, this process requires open communication between coders, billers, and case management, as well as a solid understanding of several specific rules. 

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Briefings on Coding Compliance Strategies.

Comments

0 comments on “Don't leave money on the table: Report eligible procedures under OPPS

 

    Reducing Readmissions: A Blueprint for Improving Care Transitions
  • Reducing Readmissions: A Blueprint for Improving Care Transitions

    As the healthcare industry implements reforms that will penalize hospitals for readmissions deemed unnecessary, it’s crucial...

  • The HIM Director's Guide to ICD-10

    ICD-10 is the biggest change for the HIM industry since the implementation of DRGs in the 1980s. HIM directors must take...

  • ICD-10 Trainer

    ICD-10 Trainer provides the latest news and updates related to ICD-10 regulations, and tips from HCPro experts and faculty...

  • Cardiac Anatomy and Physiology

    Cardiac coding under ICD-10-CM will require a deeper knowledge of anatomy and physiology. Code descriptions will be...

  • Coding and You

    Coding and You is written specifically to help non-coders; medical assistants, lab technicians, compliance professionals...

Most Popular