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What is the total APC payment for HCPCS codes 66984, 71020, and 78740? Round the answer to two decimal points. Explain.

What is the total APC payment for HCPCS codes 66984, 71020, and 78740? Round the answer to two decimal points. Explain.

Case Studies In Health Information Management
Case Studies In Health Information Management
3rd Edition
ISBN:9781337676908
Author:SCHNERING
Publisher:SCHNERING
Chapter5: Compliance
Section: Chapter Questions
Problem 5.15.1C
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You attended an in-service education program about the outpatient prospective payment system (OPPS) where you learned that certain Medicare Part B services are paid according to ambulatory payment classifications (APCS), which group services according to similar clinical characteristics and in terms of resources required. A payment rate is established for each APC and, depending on services provided, hospitals may be paid for more than one APC for a patient encounter. As part of the in-service, you are provided with the following information and required to answer each question by applying the formula to calculate APC payments. Outpatient Prospective Payment System (OPPS) Formula (APC Weight x Conversion Factor x Wage Index) + Add-On Payments = Payment NOTE: When a patient undergoes multiple procedures and services on the same day, multiple APCS are generated and payments are added together. APC software automatically discounts multiple APC payments when appropriate (e.g., bilateral procedure). Conversion Factor = $80.79 Wage Index = 0.9445 НСPCS Code Description АРС APC Weight 66984 Cataract procedure with intraocular lens implant 246 24.56 71046 Chest x-ray, 2 views 260 1.56 78740 Ureteral reflux study 292 3.94 What is the total APC payment for HCPCS codes 66984, 71020, and 78740? Round the answer to two decimal points. Explain.
Transcribed Image Text:You attended an in-service education program about the outpatient prospective payment system (OPPS) where you learned that certain Medicare Part B services are paid according to ambulatory payment classifications (APCS), which group services according to similar clinical characteristics and in terms of resources required. A payment rate is established for each APC and, depending on services provided, hospitals may be paid for more than one APC for a patient encounter. As part of the in-service, you are provided with the following information and required to answer each question by applying the formula to calculate APC payments. Outpatient Prospective Payment System (OPPS) Formula (APC Weight x Conversion Factor x Wage Index) + Add-On Payments = Payment NOTE: When a patient undergoes multiple procedures and services on the same day, multiple APCS are generated and payments are added together. APC software automatically discounts multiple APC payments when appropriate (e.g., bilateral procedure). Conversion Factor = $80.79 Wage Index = 0.9445 НСPCS Code Description АРС APC Weight 66984 Cataract procedure with intraocular lens implant 246 24.56 71046 Chest x-ray, 2 views 260 1.56 78740 Ureteral reflux study 292 3.94 What is the total APC payment for HCPCS codes 66984, 71020, and 78740? Round the answer to two decimal points. Explain.
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