what is HOPPS - ANS Payment system for hospital outpatient services
HOPPS - ANS Hospital Outpatient Prospective Payment System
APC - ANS Ambulatory Payment Classification
What is APC? - ANS Groups of codes with a fixed payment amount for
outpatient services
Types of APCs - ANS Surgical procedures, significant procedures, medical and
ancillary
APC - ANS Is a system for reimbursing acute care facilities for outpatient
services
, APC application - ANS Ambulatory surgical procedures, er visits, clinic visits
and outpatient services for nursing facility patients not covered in nursing facility
billing.
APC application is for: - ANS Chemotherapy, diagnostic tests and services,
implants and radiation therapy
status indicator - ANS an alphabetic character that indicates the type of each
APC and whether or how that APC is paid under the Hospital Outpatient
Prospective Payment System (OPPS)
Additional services for APC - ANS Services for patients who exhausted Part A
benefits, surgical pathology, partial hospitalization for mental health, preventive
services (colorectal cancer screening) and hospice for non-terminal illness
Status indicator C - ANS Only paid as an inpatient procedure, not paid by OPPS
Status indicator N - ANS Paid under OPPS; payment is packaged into payment
for other services including outliers. No separate APC payment.
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