A coder compares inpatient MS-DRG severity with hospital outpatient APC payment. Which distinction is accurate?
Select an answer to reveal the explanation.
Short Explanation
CC and MCC are an inpatient MS-DRG thing. Outpatient APC packaging plays by different rules—you do not paste the inpatient severity lists onto every clinic or same-day surgery claim as if they were the same engine.
Full Explanation
CMS CC and MCC lists function within the inpatient prospective payment MS-DRG methodology to assign severity tiers. Hospital outpatient APC payment generally relies on CPT/HCPCS and APC packaging logic rather than those inpatient CC/MCC lists as the severity engine. Diagnosis coding remains relevant for outpatient claims for other reasons, but APC is not driven by inpatient CC/MCC tiers.