Outpatient Billing Expert. A complete guide to APC and ASC daily billing requirements
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1 Outpatient Billing Expert A complete guide to APC and ASC daily billing requirements
2 Contents Introduction... Introduction 1 Outpatient Billing Expert Website... Introduction 2 Outpatient Billing Expert Website... Introduction 2 Hospital Outpatient Prospective Payment System... APC 1 Facility Resources Excluded From the Ambulatory Payment Classification Payment... APC 1 Clinical Diagnostic Laboratory Services... APC 1 Facility Types of Services Included in OPPS... APC 1 Facility Resources Included in APC Payments... APC 1 Discounting for Multiple Services... APC 2 Copayments... APC 2 How are hospital outpatient APC payments calculated?... APC 2 Health care Reform and Copayments for Preventive Services... APC 4 How to Determine if There Is an Outlier... APC 5 Payment Calculations for Pass-Through Devices... APC 8 Brachytherapy Sources... APC 8 Composite APCs... APC 8 Special Packaged Services...APC Clinical Diagnostic Laboratory Changes under OPPS...APC 15 Comprehensive APCs...APC 16 Guide to Table Use...APC 16 APC Group Information Category III Emerging Technology services...apc 19 Integumentary system...apc 25 Musculoskeletal system...apc 35 Respiratory system...apc 71 Digestive system...apc 85 Urinary system... APC 101 Endocrine system... APC 115 Radiology... APC 131 Pathology and Laboratory... APC 147 Medicine... APC 153 APC Tables APC Table 1. List of 2014 APCs with Their Assigned HCPCS/CPT Codes... APC 175 APC Table 2. Drugs and Medical Devices Eligible for Pass-Through Payment... APC 203 APC Table 3. Wage Index Adjustments for Hospitals... APC 205 APC Table 4. Inpatient-Only Codes... APC 231 APC Table 5. HOPD Modifiers... APC 251 APC Table 6. Revenue Codes Requiring HCPCS Codes... APC 253 APC Table 7. Packaged Services for APC 255 APC Table 8. OPPS APCs That May Be Applicable for Offset for CY APC 257 APC Table 9A. HCPCS Device Codes That Must Be Reported for OPPS Procedures... APC 261 APC Table 9B. Device Codes That Must Be Billed with an OPPS Procedure... APC 265 APC Table 10. Primary and Add-on Procedure Code Pairs... APC 267 Freestanding Ambulatory Surgery Centers... ASC 1 Revised ASC Payment System... ASC 1 ASC Procedures List... ASC 1 ASC Scope of Services... ASC 2 ASC Payment System... ASC 4 Guide to Table Use... ASC Optum360, LLC v
3 Outpatient Billing Expert APC GROUP INFORMATION: RESPIRATORY SYSTEM CPT Code Coverage Effective Date of Changes APC Group APC status Payment National Unadjusted Copayment Drainage of nose lesion 01/01/ T $84.12 $ Drainage of nose lesion 01/01/ T $ $ Intranasal biopsy 01/01/ T $ $ Removal of nose polyp(s) 01/01/ T $ $ Removal of nose polyp(s) 01/01/ T $1, $ Removal of intranasal lesion 01/01/ T $1, $ Removal of intranasal lesion 01/01/ T $1, $ Revision of nose 01/01/ T $1, $ Removal of nose lesion 01/01/ T $1, $ Removal of nose lesion 01/01/ T $3, $ Excise inferior turbinate 01/01/ T $1, $ Resect inferior turbinate 01/01/ T $1, $ Partial removal of nose 01/01/ T $3, $ Removal of nose 01/01/ T $3, $ Injection treatment of nose 01/01/ T $ $ Nasal sinus therapy 01/01/ T $ $ Insert nasal septal button 01/01/ T $1, $ Remove nasal foreign body 01/01/ X $98.25 $ Remove nasal foreign body 01/01/ T $1, $ Remove nasal foreign body 01/01/ T $1, $ Reconstruction of nose 01/01/ T $1, $ Reconstruction of nose 01/01/ T $3, $ Reconstruction of nose 01/01/ T $3, $ Revision of nose 01/01/ T $1, $ Revision of nose 01/01/ T $3, $ Revision of nose 01/01/ T $3, $ Revision of nose 01/01/ T $3, $ Revision of nose 01/01/ T $3, $ Repair nasal stenosis 01/01/ T $3, $ Repair of nasal septum 01/01/ T $1, $ Repair nasal defect 01/01/ T $3, $ Repair nasal defect 01/01/ T $3, $ Release of nasal adhesions 01/01/ T $ $ Repair upper jaw fistula 01/01/ T $3, $ Repair mouth/nose fistula 01/01/ T $3, $ Intranasal reconstruction 01/01/ T $3, $ Repair nasal septum defect 01/01/ T $1, $ Ablate inf turbinate superf 01/01/ T $ $ Ablate inf turbinate submuc 01/01/ T $1, $ Control of nosebleed 01/01/ T $84.12 $ Control of nosebleed 01/01/ T $84.12 $ Control of nosebleed 01/01/ T $84.12 $ Repeat control of nosebleed 01/01/ T $84.12 $ Ligation nasal sinus artery 01/01/ T $2, $ Ligation upper jaw artery 01/01/ T $2, $ Respiratory system A AMB D DME E ESRD H HH L LAB M MAM R PEN X PHY P REHAB 2015 Optum360, LLC APC 71
4 30930 Outpatient Billing Expert Respiratory system CPT Code Coverage Effective Date of Changes APC Group APC status Payment National Unadjusted Copayment Ther fx nasal inf turbinate 01/01/ T $1, $ Nasal surgery procedure 01/01/ T $84.12 $ Irrigation maxillary sinus 01/01/ T $ $ Irrigation sphenoid sinus 01/01/ T $ $ Exploration maxillary sinus 01/01/ T $1, $ Exploration maxillary sinus 01/01/ T $3, $ Explore sinus remove polyps 01/01/ T $3, $ Exploration behind upper jaw 01/01/ T $1, $ Exploration sphenoid sinus 01/01/ T $3, $ Sphenoid sinus surgery 01/01/ T $3, $ Exploration of frontal sinus 01/01/ T $3, $ Exploration of frontal sinus 01/01/ T $3, $ Removal of frontal sinus 01/01/ T $3, $ Removal of frontal sinus 01/01/ T $3, $ Removal of frontal sinus 01/01/ T $3, $ Removal of frontal sinus 01/01/ T $3, $ Removal of frontal sinus 01/01/ T $3, $ Removal of frontal sinus 01/01/ T $3, $ Exploration of sinuses 01/01/ T $3, $ Removal of ethmoid sinus 01/01/ T $3, $ Removal of ethmoid sinus 01/01/ T $1, $ Removal of ethmoid sinus 01/01/ T $1, $ Removal of upper jaw 01/01/09 C Nasal endoscopy dx 01/01/ T $ $ Nasal/sinus endoscopy dx 01/01/ T $ $ Nasal/sinus endoscopy dx 01/01/ T $1, $ Nasal/sinus endoscopy surg 01/01/ T $1, $ Nasal/sinus endoscopy surg 01/01/ T $1, $ Nasal/sinus endoscopy surg 01/01/ T $1, $ Nasal/sinus endoscopy surg 01/01/ T $1, $ Revision of ethmoid sinus 01/01/ T $1, $ Removal of ethmoid sinus 01/01/ T $3, $ Exploration maxillary sinus 01/01/ T $1, $ Endoscopy maxillary sinus 01/01/ T $1, $ Sinus endoscopy surgical 01/01/ T $3, $ Nasal/sinus endoscopy surg 01/01/ T $3, $ Nasal/sinus endoscopy surg 01/01/ T $3, $ Nasal/sinus endoscopy surg 01/01/09 C Nasal/sinus endoscopy surg 01/01/ T $3, $ Nasal/sinus endoscopy surg 01/01/ T $3, $ Nasal/sinus endoscopy surg 01/01/ T $3, $ Sinus endo w/balloon dil 01/01/ T $3, $ Sinus endo w/balloon dil 01/01/ T $3, $ Sinus endo w/balloon dil 01/01/ T $1, $ Sinus surgery procedure 01/01/ T $84.12 $24.11 (See APC 17 for APC status indicators and ASC 8 for ASC payment indicators.) 72 APC Deleted Code Inpatient Only Not Covered by Medicare? Questionable Coverage l New Code s Revised Code 2015 Optum360, LLC
5 Outpatient Billing Expert ASC GROUP INFORMATION: RESPIRATORY SYSTEM CPT Code Subject to Discount Effective Date of Change ASC Payment ASC Payment ASC Copayment Drainage of nose lesion Y 01/01/14 P2 $46.47 $ Drainage of nose lesion Y 01/01/14 P2 $ $ Intranasal biopsy Y 01/01/14 P3 $ $ Removal of nose polyp(s) Y 01/01/14 P3 $ $ Removal of nose polyp(s) Y 01/01/14 A2 $1, $ Removal of intranasal lesion Y 01/01/14 A2 $ $ Removal of intranasal lesion Y 01/01/14 A2 $1, $ Revision of nose Y 01/01/14 A2 $1, $ Removal of nose lesion Y 01/01/14 R2 $1, $ Removal of nose lesion Y 01/01/14 A2 $1, $ Excise inferior turbinate Y 01/01/14 A2 $1, $ Resect inferior turbinate Y 01/01/14 A2 $1, $ Partial removal of nose Y 01/01/14 A2 $1, $ Removal of nose Y 01/01/14 A2 $1, $ Injection treatment of nose Y 01/01/14 P3 $85.26 $ Nasal sinus therapy Y 01/01/14 P3 $ $ Insert nasal septal button Y 01/01/14 A2 $ $ Remove nasal foreign body N 01/01/14 P2 $54.28 $ Remove nasal foreign body Y 01/01/14 A2 $ $ Remove nasal foreign body Y 01/01/14 A2 $1, $ Reconstruction of nose Y 01/01/14 A2 $1, $ Reconstruction of nose Y 01/01/14 A2 $1, $ Reconstruction of nose Y 01/01/14 A2 $1, $ Revision of nose Y 01/01/14 A2 $1, $ Revision of nose Y 01/01/14 A2 $1, $ Revision of nose Y 01/01/14 A2 $1, $ Revision of nose Y 01/01/14 A2 $1, $ Revision of nose Y 01/01/14 A2 $1, $ Repair nasal stenosis Y 01/01/14 A2 $1, $ Repair of nasal septum Y 01/01/14 A2 $1, $ Repair nasal defect Y 01/01/14 A2 $1, $ Repair nasal defect Y 01/01/14 A2 $1, $ Release of nasal adhesions Y 01/01/14 A2 $ $ Repair upper jaw fistula Y 01/01/14 A2 $1, $ Repair mouth/nose fistula Y 01/01/14 A2 $1, $ Intranasal reconstruction Y 01/01/14 A2 $1, $ Repair nasal septum defect Y 01/01/14 A2 $1, $ Ablate inf turbinate superf Y 01/01/14 A2 $ $ Ablate inf turbinate submuc Y 01/01/14 A2 $ $ Control of nosebleed Y 01/01/14 P2 $46.47 $ Control of nosebleed Y 01/01/14 A2 $46.47 $ Control of nosebleed Y 01/01/14 A2 $46.47 $ Repeat control of nosebleed Y 01/01/14 A2 $46.47 $ Ligation nasal sinus artery Y 01/01/14 A2 $1, $ Ligation upper jaw artery Y 01/01/14 A2 $1, $ Ther fx nasal inf turbinate Y 01/01/14 A2 $1, $ Nasal surgery procedure 01/01/14 IO Respiratory System Deleted Code l New Code Revised Code 2015 Optum360, LLC ASC 59
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