Health Information Management

Tip: CMS looks to add new modifier to identify services performed prior to C-APCs

APCs Insider, September 11, 2015

Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

CMS notes that as comprehensive APC (C-APC) policies expand, the agency needs a way to identify adjunctive services provided prior to the associated primary (J1) procedure so it can compute the single C-APC encounter or "bundled payment" more accurately in the future.
 
CMS defines these adjunctive services as those that are integral, ancillary, supportive, and dependent to a comprehensive service before it's performed—such as testing leads for a pacemaker insertion or planning related services associated with stereotactic radiosurgery procedures.
 
CMS proposes to release a new HCPCS modifier that providers would report with every code that's adjunctive to a comprehensive service but billed on a different claim. 
 
This tip is adapted from “Commenting to CMS on OPPS is more important than ever" in the September issue of Briefings on APCs.



Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

    Briefings on APCs

  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular