AHA Coding Clinic® for HCPCS - 2001 Issue 4; FOR your INFORMATION

Clarification of hospital outpatient payments made under the Outpatient Prospective Payment System (OPPS)

A recently published Program Memorandum (PM) Transmittal A-01-133, addresses packaged services under the outpatient prospective payment system (OPPS). The purpose of this PM was to render advice on how to handle packaged services submitted on claims from hospital outpatient departments (bill types 12X, 13X, and 14X). The Centers for Medicare & Medicaid Services (CMS) felt that this PM was necessary because it was brought to their attention that hospital outpatient claims containing services that would be packaged services if an Ambulatory Payment Classification (APC) were payable, are not being properly handled. Packaged services are items and services that are...

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