Final APC Update for CY 2015

Event Information
Product Format
Prerecorded Event
Conference Date
Tue, Dec 09, 2014
90 minutes
Product Description

APCs Are Changing Significantly Since 2008. The Final Changes for 2015 Are Here

OPPS, in the form of APCs, is now being significantly changed. The final changes for 2015 continue to involve significantly increased packaging in several forms. Further changes for the device are dependent on APCs along with changes generated to by cost reporting changes. Other than composite APCs, we now have comprehensive APCs. These changes started in 2008 and continue to accelerate even now. Given the additional changes for CPT® and HCPCS, it will have a significant impact on APCs in 2015.

 This conference by expert speaker Duane C. Abbey, Ph.D. is going to answer questions such as:

  • Why haven’t APCs stabilized so that the year changes are minimal?
  • What does the increased bundling under APCs mean for our hospital?
  • Are there new special compliance concerns?
  • What are the general trends for the evolution of APCs?
  • How are changes in the cost reporting process affecting APCs?
  • What is the difference between composite versus comprehensive APCs?
  • How is CMS viewing add-on codes for payment purposes?
  • What is all the fuss about status indicators?
  • Are rural SCHs and EACHs affected by the proposed changes?
  • What about all of the other payment mechanisms such as cost outliers and copayment amounts?

At the end of this session, as a participant you will be able:

  • To review the many proposed and finalized changes to APCs for 2015.
  • To recognize the general trends for APCs with particular attention to increased bundling.
  • To understand how recent changes in the cost reporting process affect APCs payments.
  • To understand the complex nature of APCs and associated compliance issues including RAC concerns.
  • To review changes in grouping with particular attention to new CPT and HCPCS codes.
  • To appreciate the potential financial and operational impact of the proposed changes.
  • To understand how important it is for hospitals to comment to the proposed changes.
  • To understand the difference between composite and comprehensive APCs.
  • To review the possible impact of the proposed change on high impact areas such as observation, the Emergency Department, interventional radiology and associated areas.
  • To review changes to and trends for the Provider-Based Rule (PBR).
  • To discuss anticipated future changes and directions for APCs.

Session Highlights:

  • Review of APC Final Changes for CY2015
    • Coding/Grouping Changes
    • E/M Coding
    • Recalibration of APC Weights
    • On-Going Problem Areas
    • Cost Report Changes – Charge Compression
    • Drugs and Biologics
    • Cost Outliers
    • Interventional Radiology
    • Observation
    • Inpatient-Only Procedures
    • Commenting to the Proposed Changes
  • APC Trends
    • Increased Bundling and Packaging
    • Shifts In Realigning Payments
    • Development of Comprehensive APCs
    • Policy and Interpretive Changes
    • Impacts of CPT/HCPCS Changes
  • Provider-Based Clinic Changes
    • CMS Information Collection
    • Projecting the Future of Provider-Based Clinics
  • Associated Proposed APC Changes
    • Ambulatory Surgery Centers
    • Related Physician Changes
    • Clinical Service Area Considerations
    • RAC Audit Concerns
  • Assessing the Impact of Proposed Changes
    • Financial Impacts
    • Coding and Billing Impacts
    • Other Operational Impacts
    • APC Compliance Issues
  • The Future for APCs

Who should attend? Outpatient Clinical Staff, Nursing Staff, Physicians, Outpatient Departmental Managers, Nurse Auditors, ED Nursing Staff, Provider-Based Clinic Nursing Staff, Coding Personnel, Coding, Billing and Claims Transaction Personnel, Internal Auditing Personnel, Financial Analysts, Compliance Personnel, Cost Accounting Personnel, Charge-master Coordinators, Cost Reporting Personnel, Other Interested Personnel




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About Our Speaker

Duane Abbey Hospital Coding & Compliance Expert

 Duane C. Abbey, Ph.D. is a management consultant and president of Abbey & Abbey, Consultants, Inc., which specializes in healthcare consulting and related areas. Duane earned his graduate degrees at the University of Notre Dame and Iowa State University and has more than 20 years of experience as a consultant. He performs various types of financial analysis involving business structuring, organizational development, enrolment and other financially related concerns of organizations....   More Info
More Events By The Speaker

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