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Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules and how they impact hospital health information management systems and processes, coding, billing, and reimbursement.

To view the entire newsletter issue, click the “View Entire Issue” link below

September 2008 (Volume 9, Issue 9)	view entire issue

CMS proposes five new composite APCs, reduces drug reimbursement
CMS released the display copy of the OPPS proposed rule for fiscal year 2009 on July 3, some three to four weeks earlier than in previous years. It was officially published in the July 18 Federal Register. I, like others, was caught off guard with the early release of the rule, but after reviewing it, I believe that there aren't massive surprises. The rule contains new proposals for: Creating more composite APCs Reducing payment for separately payable drugs Expanding the quality initiative in the outpatient setting Developing new cost centers in the cost report for providers to use in the future

Avoid encoder traps to ensure coding compliance
Encoders are among the most valuable coding resources on the market, but software is just one tool for accurate code assignment. Using that tool too much at the expense of an ICD-9-CM Manual or CPT Manual can hinder-not help-correct coding. Jennifer Avery, CCS, CPC, CPC-H, a regulatory specialist at HCPro, Inc., in Marblehead, MA, says encoder dependence is reliance on an automated coding system by someone who is not familiar with the coding conventions.

Prefabricated splint codes: No easy answers
When you ask any four coders or clinicians how to handle splint coding, you're going to get four answers. Or five. The confusion is nowhere worse than with prefabricated splints. These devices occupy a middle ground between orthotics (which they are) and splints (which they can be). It's no small wonder that some clinicians react to the confusion by not using prefabricated splints if they can avoid it. No regulatory consensus Even the regulatory authorities disagree on how to code prefabricated splints.

CMS discusses MIPPA, incident-to services, and more
CMS hosted its most recent Hospital Open Door Forum (ODF) call July 17, during which it addressed several topics related to outpatient hospital services, including an update of the Medicare Improvement for Patients and Providers Act of 2008 (MIPPA), the 2009 OPPS proposed rule, and more. Following is a summary of the call.

Other recently-published articles from Briefings on APCs:

October Open Door Forum

Make determinations for self-administered drugs

Advisory panel speaks out against proposed decrease in separately payable drug reimbursement for 2009

Medicare publishes most Medically Unlikely Editsts

ICD-10 implementation timetable draws fire and support

Opinions vary on proposed payment changes to Type B EDs

Decipher integumentary codes for correct coding

Make determinations for self-administered drugs

Reminder: Medicare covers diabetes screening

Decipher integumentary codes for correct coding

Questions on E/M for hospital-based outpatient clinics

Eliminate unnecessary imaging services to meet planned APC payment reductions in 2009 OPPS proposed rule

Get ready now for ICD-10

CMS discusses MIPPA, incident-to services, and more

Prefabricated splint codes: No easy answers

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