Click here to see a replay of the 2013 OPPS Final Rule Review webinar. This webinar will prepare hospital staff for compliance with 2013 Medicare outpatient billing guidelines by reviewing the key provisions of the Medicare Outpatient Prospective Payment System (OPPS) Final Rule.

Click Here to view a replay of OPPS Final Rule Review Webinar. This session will prepare hospital staff for compliance with Medicare outpatient billing guidelines in 2012 by reviewing the key provisions of the Medicare Outpatient Prospective Payment System (OPPS) Final Rule. The session will discuss and summarize 2012 Medicare payment policy and billing guideline changes for hospitals.

Hospital managers trying to catch up on all of the changes made in the 2011 update of the hospital outpatient prospective payment system (OPPS) will be glad to know about three new transmittals issued by the Centers for Medicare & Medicaid Services (CMS). The following transmittals include continuing policies as well as new 2011 policies.

November Update: HCPCS and BETOS updates have been included in the HCPCS & CPT Pre-release Codebook! Check daily e-mail updates for the changes report, the download center for a much easier to use HCPCS data file than the one CMS publishes, and the bottom of the codebook for a series of very helpful index files.

We offer free training to all customers, and the first "Basic" training shows you how to use the system; additional classes cover coding, reimbursement and advanced research techniques.  Frequently, new users on the system want to know "Where do I find the fee schedules?" or "How can I tell what Medicare will reimburse them for a particular procedure, test?" or &qu

Hospitals have been struggling since the inception of the Outpatient Prospective Payment System (OPPS) back in 2000 with CMS’s instructions for hospitals to develop internal hospital guidelines to determine what level of visit to report for each patient. General guidelines have been provided over the course of the last 10 years such as:

CMS has revised or better defined several current policies for the supervision of outpatient services. The goal, per CMS, is “to ensure that hospital outpatient services are appropriately supervised by qualified practitioners while not impeding beneficiary access to these services, and in response to concerns raised by the hospital community.” In 2010, CMS will allow certain non-physician practitioners (NPP) (specifically physician assistants, nurse practitioners, clinical nurse specialists, certified nurse midwives, and licensed social workers) to provide direct super

On July 1, the CMS released the proposed policy changes for services provided in hospital outpatient departments and ambulatory surgical centers (ASC) for 2010, under the outpatient Prospective Payment System (OPPS). The press release is found on the Medical Release Database section within CMS: http://tinyurl.com/nmx88h.

We were wondering ourselves last week when the APC and Clinical Lab code set updates would be realeased. Our curiosity got the better of us so I reached out to a couple contacts at CMS and got information on these elusive January 1 updates. According to CMS they were still waiting on ASP data before they could finalize their APC file for 1/1/2009. The ASP data was released this week so we can expect the release of the APC data soon.

A smart user who has access to both the CCH Reimbursement Toolkit Hospital Outpatient PPS Calculator and the MediRegs APC Grouper & Calculator in RRS/Plus has asked:
What is the difference between these 2 calculators?
I thought I’d share the summary with MediBloggers. Note that you’ll see reference here to the exciting new Coding & Audit Suites which will be available shortly.

There are 2 APC Calculators Available. Let me summarize them for you here: