You attended an in-service education program about the outpatient prospective payment system (OPPS) where you learned that certain Medicare PartB services are paid according to ambulatory payment classifications (APCS), which group services according to similar clinical characteristics and in terms ofresources required. A payment rate is established for each APC and, depending on services provided, hospitals may be paid for more than one APC for a patientencounter.As part of the in-service, you are provided with the following information and required to answer each question by applying the formula to calculate APCpayments.Outpatient Prospective Payment System (OPPS) Formula(APC Weight x Conversion Factor x Wage Index) + Add-On Payments = PaymentNOTE: When a patient undergoes multiple procedures and services on the same day, multiple APCS are generated and payments are addedtogether. APC software automatically discounts multiple APC payments when appropriate (e.g., bilateral procedure).Conversion Factor = $80.79Wage Index =0.9445НСРCS CodeDescriptionАРСAPC Weight66984Cataract procedure with intraocular lens implant24624.5671046Chest x-ray, 2 views2601.5678740Ureteral reflux study2923.94What is the APC payment for HCPCS code 78740? Explain.

APC weight 3.94 Conversion factor CF $80.79 Wage Index 0.9445

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Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ

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