Health Information Management

Topic: Proposed OPPS rule digs deep into wholesale packaging

HIM-HIPAA Insider, July 30, 2007

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The outpatient prospective payment system (OPPS) has seen its fair share of changes every year since its inception in 2000. But for 2008, CMS is proposing perhaps its most drastic change yet: Wholesale packaging.

CMS is "proposing to view a service, in some cases, as not just the diagnostic or treatment modality identified by one individual HCPCS code but as the totality of care provided in a hospital outpatient encounter that would be reported with two or more HCPCS codes for component services," according to the 2008 OPPS proposed rule, released Monday.

This means that many services for which hospitals currently receive separate payment--e.g., observation, many imaging supervision and interpretation services, and diagnostic radiopharmaceuticals, among others--will no longer receive separate payment in 2008, according to CMS' proposal.

Have something to say about it? Now is the time to submit your comments to CMS. You can read the proposed rule in its entirety on the CMS Web site.

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