WEBINAR: APCs in Depth: Understanding Comprehensive APCs

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

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

 Faculty: Duane C. Abbey

Duane Abbey A management consultant and president of Abbey & Abbey Consultants, based in Ames, Iowa. For over twenty years Abbey & Abbey, Consultants, Inc. has provided superior healthcare consulting services to hospitals, hospital systems, physicians, medical clinics and integrated delivery systems.
Abbey & Abbey, Consultants, Inc. specializes in healthcare consulting primarily in the areas of: 
Payment systems - reimbursement consulting
Delivery systems - organization of healthcare delivery
Compliance - developing compliance programs - emphasis in the coding, billing and reimbursement areas
In addition to his consulting, Dr. Abbey has been an invited presenter for hospital associations, medical societies, and other groups. He has also published both articles and books on health care topics. Dr. Abbey earned his graduate degrees from the University of Notre Dame and Iowa State University.

Contact Hours: 
Nursing participants: This program has been approved for 1.8 contact hours by the Iowa Board of Nursing Approved Provider Number 339. Completion of offering required prior to awarding certificate.
All other participants: Must attend the entire Webinar and complete a Webinar critique to receive a 1.5 Hour Attendance Certificate.
4/13/2017 10:00 AM - 4/13/2017 11:30 AM
United States

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