What does Status Indicator Q2 mean?
Q2 T-Packaged Codes Paid under OPPS; Addendum B displays APC assignments when services are separately payable. (1) Packaged APC payment if billed on the same date of service as a HCPCS code assigned status indicator “T.” (2) In all other circumstances, payment is made through a separate APC payment.
What is a status indicator J1?
(Note: Status Indicator “T” means a paid service under the OPPS with separate APC payment and status indicator “J1” means that hospital Part B services are paid through a comprehensive APC.)
Where do I find status indicators for CPT codes?
The status indicator for each HCPCS code is shown in OPPS Addendum B. You can find all the information you need on the CMS website.
What does status indicator S mean?
a significant procedure
Status indicator ‘S’ represents a significant procedure, and is not discounted when you report multiple CPT codes that group to APCs with multiple ‘S’ status indicators. Status indicator ‘T’ is also a significant procedure, but multiple procedure reduction applies.
What is the opps cap?
The OPPS cap is imposed by the Deficit Reduction Act (DRA). The DRA mandates that CMS pay the lower of the OPPS rate or the PFS rate for the technical component of imaging procedures performed in the office setting.
What is a status indicator of C?
For example, a Status Indicator C means that the HCPCS is not payable if performed in either an outpatient hospital or ASC setting. A Status Indicator of N means there is no separate payment because reimbursement is packaged into the payment for other services. Status Indicator C. Inpatient Procedures.
What are the status indicators?
The status indicators (SI’s) describe how particular HCPCS codes and APCs are paid (or not paid) under OPPS, so it is important for providers to understand what the various status indicators mean.
What is the difference between APC and opps?
The hospital outpatient prospective payment system (OPPS) in place today classifies all hospital outpatient services into Ambulatory Payment Classifications (APCs). A hospital may, depending on a variety of factors, be paid for more than one APC or for more than one occurrence of the same APC at any given encounter.
What is Medicare APC rate?
APCs or “Ambulatory Payment Classifications” are the government’s method of paying facilities for outpatient services for the Medicare program. APCs are an outpatient prospective payment system applicable only to hospitals and have no impact on physician payments under the Medicare Physician Fee Schedule.
What does it mean to have a status indicator?
Status indicator or “SI” means a payment indicator that identifies whether a service represented by a CPT or HCPCS code is payable under the OPPS APC or another payment system. Only one status indicator is assigned to each CPT or HCPCS code. Status indicator shall be annunciated when the fan or system is in the “on mode”.
When does the USB status indicator go on?
Only one status indicator is assigned to each CPT or HCPCS code. Status indicator shall be annunciated when the fan or system is in the “on mode”. Verify that the green USB Status indicator is lit in the top right corner of the GUI.
What does status indicator mean in Opps APC?
Status indicator or “SI” means a payment indicator that identifies whether a service represented by a CPT or HCPCS code is payable under the OPPS APC or another payment system. Only one status indicator is assigned to each CPT or HCPCS code.