Q&A: Why are we not getting paid for observation APCs?
APCs Insider, March 21, 2014
Want to receive articles like this one in your inbox? Subscribe to APCs Insider!
Q: Our reimbursement department says that we are no longer being paid for APCs 8002 and 8003 for the observation composite services. Did CMS stop reimbursing for observation services?
A: For 2014, Level I and II Extended Assessment and Management Composite APCs were combined into one APC. CMS created new the APC 8009, Extended Assessment and Management (EAM) Composite, to provide payment for all qualifying encounters rather than recognizing two levels of EAM composite APCs. The same parameters apply for triggering the composite APC, but only one level of payment will be made.
Editor’s note: Denise Williams, RN, CPC-H, vice president of revenue integrity services at Health Revenue Assurance Associates, Inc., in Plantation, Fla., answered this question.
Want to receive articles like this one in your inbox? Subscribe to APCs Insider!
Related Products
-
Briefings on APCs
Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...
-
HIM Briefings
Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...
-
Briefings on Coding Compliance Strategies
Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...
-
Briefings on HIPAA
How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...
-
APCs Insider
This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...
Most Popular
- Articles
-
- Math can be tricky: TJC corrects ABHR storage requirement
- Air control equals infection control
- Don't forget the three checks in medication administration
- Note similarities and differences between HCPCS, CPT® codes
- Residency coordinators’ responsibilities
- The consequences of an incomplete medical record
- Five ways to safeguard your patients' valuables
- OB services: Coding inside and outside of the package
- Practice the six rights of medication administration
- Study: Shorter shifts reduces residents’ attentional failures
- E-mailed
-
- OSHA HazCom updates include labeling, SDS requirements
- Air control equals infection control
- Plan of Care Supports Documentation of Homebound Status
- Patient classification systems to coordinate patient care
- Nursing's growing role
- Note similarities and differences between HCPCS, CPT® codes
- Note from the instructor: CMS clarifies billing guidelines on proper billing for drugs in a single-dose or single-use vial, including billing for discarded drugs
- Fracture coding in ICD-10-CM requires greater specificity
- Follow these tips to properly report bladder catheter codes
- Five ways to safeguard your patients' valuables
- Searched