Tip: CMS proposes extensive APC reconfiguration in 2016 OPPS proposed
APCs Insider, September 4, 2015
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For 2015, CMS finalized changes to reconfigure and consolidate ophthalmology and gynecology APCs. The agency is proposing to expand that to include nine new clinical families for 2016:
- Diagnostic tests and related services
- Endoscopy procedures
- Gastrointestinal procedures
- Imaging services (specifically diagnostic radiology and nuclear medicine)
- Incision and drainage and excision/biopsy procedures
- Orthopedic procedures
- Skin-related procedure (combining debridement and destruction with skin procedure APCs)
- Urology and related procedures
- Vascular procedures
Providers should anticipate continued changes as CMS continues to move through clinical families.
This tip is adapted from “CMS proposes massive APC reconfiguration, updates 2-midnight rule" in the September issue of Briefings on APCs.
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