Catalog Number : caa1995
Title : APCs In-Depth: Understanding Comprehensive APCs
Speaker : Duane Abbey

Webplay Recording Date : 4-13-2017
Webplay Price : $ 150 for two weeks viewing

Webinar Description:

Starting in 2008 CMS started increased bundling for APCs. At first this was simply at the procedure level generally using SI="N" in order to effect the bundling. Then Composite APCs were developed and the evolution continued on to Comprehensive APCs or C-APCs. C-APCs represent significant bundling using the "J1" and "J2" status indicators. For 2016 and 2017 CMS has moved rapidly to increase the number of C-APCs and this trend is likely to continue. The basic philosophy is that APCs in general represent a Prospective Payment System in which there should be significant bundling similar to that which is found in DRGs. Historically, the precursor to APCs was APGs (Ambulatory Patient Groups) in which there was significant bundling through Significant Procedure Consolidation. With the rapid deployment of many C-APCs, hospitals have a very difficult time assessing the financial impact that C-APCs engender.

Webinar Objectives:

• review the various bundling techniques used by APCs
• discuss the historical perspective of Significant Procedure Consolidation found with APGs
• explain the use of Status Indicators to drive the APC grouping process and thus the adjudication of claims
• review the types of APC categories that are amenable to C-APCs
• discuss what is bundled or not with C-APCs
• review the potential of statistical variation within the C-APCs
• list different scenarios for C-APCs in order to develop cost versus payment estimates for a given hospital
• discuss steps that can be taken to mitigate the impact of C-APCs

A few of the topics that will be covered:

• Review of APCs
  • Development of APCs
  • Rejection of APGs
  • Bundling Under APCs
  • Technical Issues and Use of Status Indicator Codes
  • Changes Within APCs
  • Statistical Variations
• APC Trends
  • Increased Bundling and Packaging
  • Impacts of CPT/HCPCS Changes
  • Coverage and Compliance Issues
• Review of C-APCs
  • Criteria For Developing
  • 25 New C-APCs for 2017
  • Observation o Surgical
  • Airway Endoscopies
  • Upper GI Procedures
  • Urology Procedures
  • Extraocular Procedures
  • Adjudication Issues
• Assessing the Impact of C-APCs
  • Financial Impacts
  • Coding and Billing Impacts
  • Other Operational Impacts
  • Modeling the Financial Impact of C-APCs
  • Steps to Optimize Reimbursement Under C-APCs
• The Future for APCs

Target Audience:

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, Revenue Cycle Specialists, Compliance Personnel, Cost Accounting Personnel, Chargemaster Coordinators, Cost Reporting Personnel, Other Interested Personnel

Contact Hours:

• Nursing participants: Instruct-online has approved this program for 1.8 contact hours, Iowa Board of Nursing Approved Provider Number 339.
  • All other participants: Must attend the entire Webinar and complete a Webinar critique to receive a 1.5 Hour Attendance Certificate for each program.

Completion of offering required prior to awarding certificate.

Full tuition is refunded immediately on request if the participant has not been sent the program materials and instructions. Once the instructions (including access codes) have been sent, a full refund will be issued only after the program runs and it is verified that the participant did not access the program.