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G0416 , 88307 and 88333

Kathy Posted Fri 03rd of April, 2015 08:34:21 AM

Are the above codes packaged with the "Primary Service" for the Hospital APC's. I have not been able to find a complete list of codes in the web links "Ask an Expert" referred me. If there is one specific web link that has a clear list of codes that would be helpful. But, if it is a search and hunt through many government web sites (as provided before) please give me the specific answer to the 3 above codes. Many Thanks...-kathy

SuperCoder Answered Mon 06th of April, 2015 04:01:18 AM

Hi,

APCs or Ambulatory Payment Classifications are the United States government's method of paying for facility outpatient services for the Medicare (United States) program.APCs are an outpatient prospective payment system applicable only to hospitals. Physicians are reimbursed via other methodologies for payment in the United States, such as Current Procedural Terminology or CPTs.

APC payments are made to hospitals when the Medicare outpatient is discharged from the Emergency Department or clinic or is transferred to another hospital (or other facility) which is not affiliated with the initial hospital where the patient received outpatient services. Although APCs began through the federal system of Medicare, they have also been considered for adoption by state programs, such as Medicaid, and other third-party private health insurers. If the patient is admitted from a hospital clinic or Emergency Department, then there is no APC payment, and Medicare will pay the hospital under inpatient Diagnosis-related group DRG methodology.

APC codes for the above mentioned codes:

APC code:0343-88307

APC code:0344-G0416

APC code:0433- 88333

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