Reader Question: Unrelated Procedures

Question: How many different APCs can I bill at once for the same patient? In other words, if someone has several different unrelated procedures performed in different outpatient departments, how do I bill them?

New Jersey Subscriber

Answer: Each service would be billed with the related procedure code and associated with the revenue center code in the case of procedures, for the area/department where the service was provided. Medicare will assign the procedures and services to the appropriate ambulatory payment classification (APC) group(s) and reduce the payment rate for multiple services according to its established formula.

The source for these two Reader Questions is Caral Edelberg, CPC, CCS-P, president of Medical Management Resources, an emergency medicine coding company in Jacksonville, Fla.


- Published on 2000-11-01