Under hospital OPPS APC payment, what commonly happens to many ancillary outpatient services billed with a significant procedure?
Select an answer to reveal the explanation.
Short Explanation
Think of a significant procedure APC as the main entrée—lots of side dishes get rolled into that one plate’s price. Under OPPS packaging, many ancillaries don’t get their own separate check. Coders still report them, but payment often rides with the primary procedure.
Full Explanation
Under the Outpatient Prospective Payment System, packaging incorporates payment for many adjunct services into the APC payment for a significant procedure or primary service. Reporting remains important for data integrity, but separate APC payment is not expected for packaged items. This differs from MS-DRG inpatient grouping and does not mean services are deleted from the claim.