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Title: Hospital Outpatient Prospective Payment System – APC 2016 Update

Original Presentation Date: Thursday, December 17, 2015

Learning Objectives:

  • A summary of the major changes impacting coding and billing of hospital outpatient services
  • Descriptions of the bundling of services and expansion of packaged items and services
  • A review of the impact of these changes on hospital outpatient ER and clinic visit reporting
  • An introduction to new rules and associated new codes including pertinent background information
  • A review of revised and modified billing rules and associated codes
    • A discussion of their impact on coding and related coding and documentation issues
  • A discussion of changes to conversion factor and payment implications
  • An overview of other changes of major interest

Presenter: Richard R. Cooley, BA, CCS

Richard R. Cooley has more than 15 years in healthcare consulting. He has developed an expertise in hospital outpatient and inpatient coding, including professional split billing and E/M coding, admissin criteria, reimbursement and compliance, and charge master reviews. His area of expertise include Medicare reimbursement for the Medicare Outpatient Prospective Payment System (OPPS), Medicaid Ambulatory Payment Groups (APG), as well as commercial payers and professional reimbursement. He is a certified coder with AHIMA (CCS). Richard earned his Bachelors degree from Hobart College.

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