Health Information Management

Pay-per-view: CMS plans to introduce 29 comprehensive APCs in 2015

APCs Insider, February 28, 2014

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CMS proposed creating 29 comprehensive APCs from the 39 existing device-dependent APCs, but delayed implementation until 2015.
The concept of the comprehensive APC is that a single APC payment will be made, as CMS will assume all other services provided on the same claim to be adjunctive and supportive of the primary service.
In the proposed rule, CMS did not address how claims with more than one of the 136 2012 HCPCS codes (i.e., multiple J1 HCPCS) would be treated, or which HCPCS code would be defined as the primary service, but will address that for 2015 in a complex process described in detail in the final rule.
Continue reading CMS dramatically increases packaging in 2014 OPPS Final Rule on HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the February issue.

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