Medicare's Outpatient Prospective Payment System: Understanding Status Indicators

Hours: 0.50
# Course Code: REL-RCC-OPPS-C03

This course explains details of the Medicare Outpatient Prospective Payment System (OPPS), focusing primarily on the importance of Ambulatory Payment Classification (APC) status indicators and the use of Medicare addenda A and B for identifying payment.

Course Description

This course explains details of the Medicare Outpatient Prospective Payment System (OPPS), focusing primarily on the importance of Ambulatory Payment Classification (APC) status indicators and the use of Medicare addenda A and B for identifying payment.

Certificates

Certificates provided by accrediting body (1 Match)

American Health Information Management Association

0.5 HOURS

“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.”

Course Details

Course Code: REL-RCC-OPPS-C03

Hours: 0.5

Type: Online Course

Content Expiration Date: 12/31/2025

Learning Objectives:
Identify the APC status indicators.
Describe the meaning of the status indicators.
Recognize composite APCs and explain how they are reimbursed.
Distinguish comprehensive APCs and explain what is included in their payment.

Outline:

Section 1: Introduction

About This Course

Learning Objectives

Overview

Addenda A and B

Section 2: Packaging

Packaging

Packaging That Results in an APC Payment

Status Indicator Q1

Status Indicator Q2

Status Indicator Q4

Payment for Combined Packaged Services

Packaged and Combined Services Q1 and Q2

Section 3: Composite APCs

Composite APCs

Status Indicator Q3

Review

Ultrasound as a Composite Service

Determining Payment Rates for Composites

Review

Section 4: Comprehensive Payment

Comprehensive APCs (C-APCs)

Section 5: Blood

Blood and Blood Products

Blood Donation

Pass-Through Drugs and Biologicals

Non-Pass-Through Drugs and Biologicals

Status Indicator T Services

Review

Section 6: Conclusion

Course Summary

Course Contributors

Resources

References

Glossary

Subject Matter Expert: Jean C. Russell, MS, RHIT

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.

Instructor: Alison Kazmierczak

Alison has twenty-nine years of healthcare and information system experience, eleven of those years consulting at hospitals across the United States. Her areas of expertise include all aspects of Soarian Financials Revenue Management including Service Catalog (CDM), Service Maps, CRDT, General Ledger, Contracts, Claims, Reports, and all Master Files. Alison has provided analysis and reconfiguration for optimization, new build services, legacy support for hospital systems moving to a new platform, and training.

Target Audience:
The target audience for this course is: Coding Specialists; in the following settings: Acute Care Facility.

Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.

Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.

Accommodations
If you require special accommodations to complete this module, please contact Relias Customer Support here.

Medicare's Outpatient Prospective Payment System: Understanding Status Indicators

This course explains details of the Medicare Outpatient Prospective Payment System (OPPS), focusing primarily on the importance of Ambulatory Payment Classification (APC) status indicators and the use of Medicare addenda A and B for identifying payment.

$ 35.0 Paid $35.00 $35.00

American Health Information Management Association

$ 35.0 Paid $35.00

$35.00