This lesson will explain how to obtain Medicare Outpatient Prospective Payment System (OPPS) program information available through the online manuals, transmittals, MedLearn articles, and website maintained by the Centers for Medicare and Medicaid Services (CMS).
“This program has been approved for 0.50 continuing education unit(s) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.”
This activity is approved for 0.50 contact hours.
Section 1: Introduction
About This Course
Section 2: Manual Basics
The Centers for Medicare and Medicaid Services Manual Information
Updates to Manuals
Section 3: Internet Only Manuals
Crosswalks from Paper-Based to Internet-Only Manuals
Internet-Only Manual Organization
Internet only Manuals: Pub no. 100-02, Chapter 6
Internet Only Manual: Pub No. 100-04 Chapter 4
Internet Only Manuals: Examples
Section 4: Other Resources
The Outpatient Prospective Payment System Final Rule
The Centers for Medicare and Medicaid Services Website
Section 5: Conclusion
Expert Reviewer: Jean C. Russell, MS, RHIT
Richard has more than eighteen years in healthcare consulting. He has developed an expertise in hospital outpatient and inpatient coding, including professional split billing and E/M coding, admission criteria, reimbursement and compliance, and charge master reviews. His areas of expertise include Medicare reimbursement for the Medicare Outpatient Prospective Payment System (OPPS), Medicaid Ambulatory Payment Groups (APGs), as well as commercial payers, and professional reimbursement. He is a certified coder with AHIMA (CCS). Richard earned his Bachelors from Hobart College.Disclosure: Richard R. Cooley, BA, CCS has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
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.Disclosure: Jean C. Russell, MS, RHIT has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
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