Course Code: REL-RCC-OPPS-C03
Hours: 0.5
Type: Online Course
Content Expiration Date: 12/31/2029
Learning Objectives:
Identify the APC status indicators.
Describe the meaning of the status indicators.
Recognize composite APCs and explain how they are reimbursed.
Distinguish comprehensive APCs and explain what is included in their payment.
Outline:
Section 1: Introduction
Introduction
About This Course
Overview
Addenda A and B
Comprehensive APCs (C-APCs)
Review
Key Takeaways
Section 2: Packaging
Packaging
Overview
Packaging That Results in an APC Payment
Status Indicator Q1
Status Indicator Q2
Status Indicator Q4
Payment for Combined Packaged Services
Packaged and Combined Services Q1 and Q2
Review
Key Takeaways
Section 3: Composite APCs
Composite APCs
Overview
Status Indicator Q3
Ultrasound as a Composite Service
Determining Payment Rates for Composites
Review
Key Takeaways
Section 4: Blood
Blood and Blood Products
Billing and Payment
Blood Drive
Processing and Storage
CPT/HCPCS Codes
Blood Donation
Processing
Blood Transfusion
Hospital Charge
Pass-Through and Non-Pass-Through Drugs and Biologicals
Pass-Through Drugs and Biologicals
Non-Pass-Through Drugs and Biologicals
Status Indicator T Services
Review
Key Takeaways
Section 5: Conclusion
Course Summary
Course Information
Course Contributors
Resources
References
Subject Matter Expert: Jean C. Russell, MS, RHIT
Jean Russell has over thirty years of healthcare and information system experience. Her areas of expertise include the Medicare outpatient prospective payment systems (APCs, and APGs), as well as ICD-10-CM/PCS training, Charge Description Master (CDM), admission status reviews, and outpatient coding and compliance. She is a frequent speaker at the national, state and local levels for HFMA and AHIMA professional groups. Jean has her Masters from the University of Houston in Biomedical Engineering; her Bachelors from Colgate University in Biology; and her RHIT from the independent study program through the American Health Information Management Association.
Subject Matter Expert: Brandi D. Burgett, CCS, CPC
Brandi has over twenty-five years of medical billing and coding experience. Her areas of expertise include beginning-to-end revenue cycle operations, hands-on coding for multiple outpatient specialties, and medical record auditing. Prior to medical coding, Brandi was a Team Lead for a large team of pediatric specialty providers in Virginia.
Reviewer: Alison Kazmierczak
Alison has twenty-nine years of healthcare and information system experience, eleven of those years consulting at hospitals across the United States. Her areas of expertise include all aspects of Soarian Financials Revenue Management including Service Catalog (CDM), Service Maps, CRDT, General Ledger, Contracts, Claims, Reports, and all Master Files. Alison has provided analysis and reconfiguration for optimization, new build services, legacy support for hospital systems moving to a new platform, and training.
Target Audience:
The target audience for this course is: Healthcare Billing and Coding; in the following settings: Ambulatory Care.
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To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Course Delivery Method and Format
Asynchronous Distance Learning with interactivity which includes quizzes with questions/answers, and posttests.