Health Information Management

Pay-per-view: CMS replaces clinic E/M visit levels with single G-code

APCs Insider, January 31, 2014

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One of the most radical changes CMS proposed in this year’s OPPS final rule was to collapse the five levels of E/M CPT® codes and replace them with three new HCPCS G-codes, including one APC for all clinic visits, one for all Type A ED visits, and one for all Type B ED visits.
“Fortunately, CMS did not finalize what it proposed in full, as this could have had a major impact on revenue—particularly ED revenue for hospitals—given that CMS moved forward with so much packaging,” says Jugna Shah, MPH, president and founder of Nimitt Consulting.
Instead, in the 2014 OPPS Final Rule, CMS only finalized the collapsing of E/M codes for clinic visit APCs. For 2014, HCPCS code G0463 replaces CPT codes 99201–99205 and 99211–99215, and is assigned to APC 0634.
 
Continue reading CMS replaces clinic E/M visit levels with single G-code on HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the February issue.



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