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APCs or Ambulatory Payment Classifications are the United States government's method of paying for facility outpatient services for the Medicare (United States) program. A part of the Federal Balanced Budget Act of 1997 made the Centers for Medicare and Medicaid Services create a new Medicare "Outpatient Prospective Payment System" (OPPS) for hospital outpatient services -analogous to the ...
The National Correct Coding Initiative (NCCI) is a Centers for Medicare & Medicaid Services (CMS) program designed to prevent improper payment of procedures that should not be submitted together. There are two categories of edits: Physician Edits: these code pair edits apply to physicians, non-physician practitioners, and Ambulatory Surgery Centers
Outpatient surgery, also known as ambulatory surgery, day surgery, [1] day case surgery, or same-day surgery, is surgery that does not require an overnight hospital stay. [note 1] The term “outpatient” arises from the fact that surgery patients may enter and leave the facility on the same day. The advantages of outpatient surgery over ...
The CPT code set describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among physicians, coders, patients, accreditation organizations, and payers for administrative, financial, and analytical purposes.
The Accreditation Association for Ambulatory Health Care (AAAHC), founded in 1979, is an American organization which accredits ambulatory health care organizations, including ambulatory surgery centers, office-based surgery centers, endoscopy centers, and college student health centers, as well as health plans, such as health maintenance organizations and preferred provider organizations.
Headquartered in Chicago, HFAP is an accreditation organization with authority from Centers for Medicare and Medicaid Services. [1] HFAP provides accreditation programs for hospitals, clinical laboratories, ambulatory surgical centers, office based surgery, and critical access hospitals.
Outpatient ambulatory surgery center facility licensing per Chapter 1 [42] can vary, with three options: (1) Medicare certification and regulation by the Licensing and Certification Division of the California Department of Public Health; (2) accreditation by one of five different accrediting agencies and oversight by the Medical Board of ...
Medical billing practices vary across states and healthcare settings, influenced by federal regulations, state laws, and payor-specific requirements. Despite these variations, the fundamental goal remains consistent: to streamline the financial transactions between physicians and payors, ensuring access to care and financial sustainability for ...