The Ambulatory Patient Group Operations Manual
An informative and comprehensive resource for understanding the tenets and features of the APG payment system which is expected to be used in outpatient payment reforms. This manual explains how to implement and manage the APG system.
70 pages matching logic charts in this book
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Background and History of Ambulatory Patient Groups
The Basics of the APG System
The Basics of APG Grouping Logic
16 other sections not shown
ambulatory ancillary services and/or Anoscopy APG categories APG grouper APG implementation APG system APG weights APG-Type Payment Systems Arthrocentesis Arthroscopy Biopsy bundling Case-Mix Index Cast Removal Charge Master Chemotherapy Chemotherapy Drugs claims clinical coding personnel coding systems Complex computer system cost accounting Cost Outliers cost reports CPT codes Debridement and Destruction Destruction 10 Simple developed diagnosis codes Dilation and Curettage discounting schedule Drainage 6 Simple DRGs E/M codes Endoscopy example Excision FIGURE Gastrointestinal given APG grouping process Hand and Foot HCFA Hematologic ICD-9-CM diagnosis codes Incision and Drainage inpatient laboratory logic charts medical necessity Medicare multiple Musculoskeletal outpatient service providers overall patient payment rates percent Proctosigmoidoscopy radiology RBRVS reimbursement resource utilization Segment Eye Procedures Significant Procedure Significant Procedure Consolidation Simple Debridement Simple Incision Simple Skin Repair surgery surgical Tendon Tests Therapeutic third-party payers types Urinary Urinary Catheterization version 2.0 versus Window-of-Service