Outpatient Definitions and Methodology
The Hospital Outpatient Prospective Payment System (OPPS) Limited Data Set does not include APC assignments. AHD assigns APC by using a cross walk of HCPCs/CPT to addendum B of the final rule for the fiscal year. This methodology, however, does not assign the recently introduced “composite APCs” which are a combination of multiple HCPCs/CPT codes that, when billed together under certain circumstances, are bundled together. An algorithm to reliably make composite APC assignments is under development and APC statistics will be updated upon its completion. In the meantime, the APC information in the APC table on the Outpatient Report does not include composite APCs.
Examples of Composite APCs for FY 2010 are: