Government Update: HCFA Provides for Self-directed Training

The Health Care Financing Administration (HCFA) offers several resources that facilities and individuals can use to train themselves to handle ambulatory payment classifications (APCs). All the fiscal intermediaries (FIs) offered training in May and June, but HCFA has no current plans to repeat those classes, so future training must be self-directed. FIs have been asked to monitor what happens to claims under APCs and focus on providers that may need help.

HCFA has produced a list of reminder items (www.hcfa.gov/medlearn/opps3.doc) that tells providers about the most common problems and how to deal with them. The document reminds providers to:

Provide a date of service for every line-item HCPCS code (the most common problem with APC billing).

Properly report units of service (document provides reference to instructions).

Check the most current version of the inpatient-only list of procedures.

HCFA will update this document as it becomes aware of more frequently encountered issues. This document also addresses some technical problems that affect a few claims.

Another useful resource is the training manual used during the original FI training sessions, which is now posted on the Web site at www.hcfa.gov/medlearn/ refopps.htm. This is the most versatile tool available to healthcare providers, offering links to the final regulations, implementation instructions, program memorandums and code editor instructions.

HCFA also has created three e-mail discussion groups (one for hospitals, one for community mental health services and one for other affected groups) that have so far attracted almost 5,500 subscribers. To subscribe, go to www.hcfa.gov/medlearn/listserv.htm.

The best tool that hospitals can use at this point is the Web site, where they can find the training manual, final regulations, implementation instructions, program memorandums and code editor instructions.

Interested coders, clinicians, or administrators should refer to HCFAs outpatient prospective payment system (OPPS) page (www.hcfa.gov/medicare/hopsmain.htm) frequently to check for updates and additional
education resources.

- Published on 2000-10-01