tci Outpatient Facility Coding Alert - 2014 Issue 2

Reimbursement: Watch 6 Letters to Know Whether to Expect OPPS Payment Approval or Refusal

Tip: Keep tabs on the Status Indicators along with alternate HCPCS codes. When you want to verify whether a procedure is payable under Ambulatory Payment Classifications (APCs), your first checkpoints are Status Indicators (SIs). Not having clarity on what these are or how to use them can seriously sideline your claims. Read on for a refresher on what each SI means to your coding and billing. Basics: The SIs are divided into 23 categories and tie in with certain HCPCS or CPT® codes. The SI(s) are defined in Addendum D1 of the Outpatient Prospective Payment System (OPPS) Final Rule...

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