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

APCs Insider, October 10, 2008

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Without changing the way that physicians order tests, hospitals aren't prepared for Medicare's business direction for outpatient services reimbursement, and paying one price is the essence of prospective payment, says Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, FCS, PCS, CDIS.

Packaging is part of a restructuring that has been a long time coming, says Krauss, senior coding and chargemaster consultant at QHR in Brentwood, TN.

"[Medicare] started out with good intentions and expanded to the point where they were paying for every little thing," says Krauss. "Now, in an effort to curtail the growth in Medicare outpatient reimbursement to hospitals, facing annual increases in volume and intensity of services provided to Medicare beneficiaries, they are leaning toward one price."

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