Health Information Management

Tip: Understand Q status indicator subcategories

APCs Insider, May 22, 2009

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The 2009 OPPS final rule further divided the Q status indicator into three subcategories, with separate status indicators for each subcategory:
  • Q1, for STVX-packaged
  • Q2, for T-packaged codes
  • Q3, for codes subject to payment as part of a composite

TheSTVX-packaged codes (status indicator Q1) are packaged when billed on the same date of service with any other code with a status indicator of S, T, V, or X. If not, they are separately payable under a separate APC.

The T-packaged codes (status indicator Q2) are packaged only if they are billed on the same date of service with any other codes with a T status indicator. If not, they are separately payable under a separate APC.

Codes subject to payment as part of a composite (status indicator Q3) are packaged into the composite rate when all criteria for that composite are met. Otherwise, Q3 status indicator services may become separately payable, if assigned to a separate APC, or packaged into other services, if not.

If you report more than one STVX- or T-packaged code without a separately payable service into which it would otherwise be packaged, CMS makes separate payment only for the highest-paying service and packages all others into that code.

This tip was adapted from the article “Review these important CY 2009 OPPS status indicator changes” from the May issue of Briefings on APCs.



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