What does APC stand for?

The Ambulatory Payment Classification (APC) payment for outpatient surgical procedures includes operating time, supplies, medication, anesthesia, antibiotics, and a routine recovery period of four to six hours but can be up to 24 hours, Hale points out.

Composite APCs set for imaging As part of its Outpatient Prospective Payment System (OPPS) payment rule for 2009, the Centers for Medicare & Medicaid Services (CMS) has established a multiple imaging composite methodology, which means it will provide a single composite ambulatory payment classification (APC) payment each time a hospital bills more than one procedure from an imaging "family" on a single date of service.

CMS also is planning to establish five imaging categories or composite ambulatory payment classifications (APCs) to further streamline reimbursement when patients have multiple imaging procedures of the same type or category completed in a single visit.

GAO determined that the payment groups in the OPPS, known as ambulatory payment classification (APC) groups, accurately reflect the relative cost of procedures performed in ASCs.

Smith & Nephew pic, Largo, FL and Advanced Tissue Sciences, La Jolla, CA announced that Dermagraft Human Fibroblast-Derived Skin Substitute has received an Ambulatory payment Classification (APC) pass-through code under the Hospital Outpatient Prospective Payment System from the Centers for Medicare & Medicaid Services (CMS - formerly HCFA).

3M Health Information Systems has introduced a new diagnostic software tool, the 3M APC Performance Profile, designed to assist hospital outpatient care providers and improve payment performance and compliance under the Medicare Ambulatory Payment Classification (APC) outpatient prospective payment system.

Under the contract, 3M will help HCFA evaluate comments on the proposed use of ambulatory payment classifications as the basis for prospective payment for Medicare hospital outpatient and ambulatory surgical center services.

The APC Diagnostic Review will include training health information management and other hospital staff in the Ambulatory Payment Classification System and new coding requirements.