You attended an in-service education program about the outpatient prospective payment system (OPPS) where you learned that certain Medicare PartB services are paid according to ambulatory payment classifications (APCS), which group services according to similar clinical characteristics and in terms ofresources 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 patientencounter.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 APCpayments.Outpatient Prospective Payment System (OPPS) Formula(APC Weight x Conversion Factor x Wage Index) + Add-On Payments = Payment%3DNOTE: When a patient undergoes multiple procedures and services on the same day, multiple APCS are generated and payments are addedtogether. APC software automatically discounts multiple APC payments when appropriate (e.g., bilateral procedure).Conversion Factor = $80.79Wage Index = 0.9445%3DНСPCS CodeDescriptionАРСAPC Weight66984Cataract procedure with intraocular lens implant24624.5671046Chest x-ray, 2 views2601.5678740Ureteral reflux study2923.94What is the APC payment for HCPCS code 66984? Explain.

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What is the APC payment for HCPCS code 66984? Explain.

Comprehensive Medical Assisting: Administrative and Clinical Competencies (MindTap Course List)

6th Edition

ISBN:9781305964792

Author:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa

Publisher:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa

Chapter5: The Therapeutic Approach To The Patient With A Life-threatening Illness

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Question

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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
%3D
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
%3D
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 APC payment for HCPCS code 66984? Explain.

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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…
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…
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