Ambulatory Payment Classification System (APC) Calculation Of APCs Is Available In The Grouper In The 3M Coding And Reimbursement System. Hopefully You Have Had An Opportunity To Use This Or Another Grouper In Your Coding Courses. (We Will Discuss Encoder
- Ambulatory Payment Classification System (APC) Calculation ofAPCs is available in the Grouper in the 3M Coding and ReimbursementSystem. Hopefully you have had an opportunity to use this oranother grouper in your Coding courses. (We will discuss encodersand groupers in the Discussion section of the course.)
- APCs are calculated in a similar manner as MS-DRGs. They arebased on the procedure codes and a few other elements. What are theother elements?
- Remember that in the CPT/HCPCS code set there are packaging andbundling of services, so too are there packaging and bundling ofthe payments. Unbundling of the package is considered fraud.
- What is packaging as used in this context?
- What is bundling as used in this context?
Ambulatory Surgical Center
- What standards must be met in order for a facility to beconsidered a Medicare-certified ASC?
- Review the information and calculations below. One is for thehospital outpatient setting while the other is for the AmbulatorySurgery Center. The calculations are done, and you do not need toknow how to calculate these on your own. However, please note thatthe final reimbursement for the hospital is much greater than forthe ASC.