Respiratory Question for the Week of April 22, 2019

Question:

What status do codes receive that fall under “composite APC” procedures?

Answer:

Under the Outpatient Prospective Payment System (OPPS) reimbursement guidelines, some services are designated as “special packaged” or “composite Ambulatory Payment Classification (APC)” procedures. A code that falls into these groups is assigned an APC status indicator of “Q3” and categorized as conditionally packaged. This means that the procedure will be reimbursed according to APC assignment when it appears on a claim with no other status indicator “Q3” services (codes that may be paid through a composite APC).

This question was answered in our Coding Essentials for RT/Pulmonary Function. For more hot topics relating to respiratory services, please visit our store or call us at 1.800.252.1578, ext. 2.

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