Health Information Management

Tip of the week: Bill packaged services

APCs Insider, March 16, 2007

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Although providers do not receive additional reimbursement for providing the packaged service, it is important to bill them for a number of reasons, including to

  • ensure accurate Medicare claims data that will help CMS accurately pay hospitals in the future
  • accurately capture your hospital's utilization of resources
  • ensure that your hospital receives credit for the cost of that item if there is an outlier payment--or some other cost-based payment--available for the case

And in light of the fact that CMS announced in its 2007 final rule for the outpatient prospective payment system (OPPS) that it will pay separately for six normally packaged codes when they are the only service that providers report without any other separately payable item on the claim, it's more important now than ever that coders distinguish between bundled versus packaged service in the hopes that additional codes might be added to this list in the future.

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