APCs: What to Expect for 2015

Event Information
Product Format
Prerecorded Event
90 Minutes
Product Description

Review the  Proposed Changes to  APCs For CY 2015

OPPS, in the form of APCs, is now being significantly changed. The proposed changes for 2015 continue to involve significantly increase packaging in several forms. Further changes for device dependent APCs along with changes generated by cost reporting changes. Besides composite APCs, we now have comprehensive APCs. These changes started in 2008 and continue to accelerate. Given additional changes for CPT and HCPCS,expert speaker Duane Abbey will walk you through the proposed APCs changes in 2015.

In this 90-minute session, you will get answers to the following questions:

  • 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 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?

Session objectives: 

  • To review the many proposed 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 outline:

  • Review of APC Proposed 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
    • 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, Chargemaster Coordinators, Cost Reporting Personnel, and 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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