Health Information Management

Tip: CMS proposes new C-APCs for 2016

APCs Insider, September 25, 2015

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CMS proposes adding new comprehensive APCs (C-APC) in 2016, but did not change the logic or methodology for paying for these procedures. The new C-APCs are:
  • 5165, Level 5 ENT Procedures
  • 5492, Level 2 Intraocular Procedures
  • 5416, Level 6 Gynecologic Procedures
  • 5361, Level 1 Laparoscopy
  • 5362, Level 2 Laparoscopy
  • 5123, Level 3 Musculoskeletal Procedures
  • 5375, Level 5 Urology and Related Services
  • 5881, Ancillary Outpatient Services When Patient Expires
  • 8011, Comprehensive Observation Services
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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