Reimbursement 101 2011 - Cardinal Health

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Reimbursement Terminology 6 • ICD-9-CM (diagnosis codes). - Internal Classification of Diseases, Ninth Revision, Clinical Modification – Codes used to identify diseases, symptoms, conditions, problems, complaints or other reasons for a medical service – Transitioning to ICD-10-CM – Implementation date set for Oct Oct.1, 1 2013 © Copyright 2011, Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
Reimbursement Terminology 7 • HOPPS – Hospital p Outpatient p Prospective p Payment System – Payment methodology used by Medicare to reimburse hospitals for outpatient procedures and supplies supplies. • APC – Ambulatory Payment Classification – Under HOPPS CPT/HCPCS codes are mapped pp to an APC for payment. The APC has a payment rate assigned to it and any CPT/HCPCS code mapped to a given APC will have that particular payment rate. © Copyright 2011, Cardinal Health, Inc. or one of its subsidiaries. All rights reserved.
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Page 39 and 40: Coding 39 CPT/HCPCS codes • The n
Page 41 and 42: Coding Modifiers • Two character
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Page 45 and 46: Coding > Claim Forms • Hospitals
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Nuclear Medicine Reimbursement 101
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Reimbursement 101 2011 - Cardinal Health

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