Wiki Audits

[jaud63]

Does anyone ever receive an audit on diagnosis for inpatient professional fees based on APC's?

Does anyone code based on probables, possibles, and maybe's for inpatient professional fees billed on the outpatient HCFA billing form?

Thanks in advance.

 

[CodingKing]

APC's are an outpatient facility based reimbursement, not physician related. Probably, suspected and rule out can only be billed on inpatient Facility UB claims. Its not acceptable for professional inpatient claims

 

[jaud63]

APC's

Thanks for the information. That's what I've always understood.