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Reimbursement


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Reimbursement C-Code Finder

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Reimbursement C-Code Finder »

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编码和报销指南

Plastic & Reconstructive Surgery

*Cook’s policy is to offer only information that is complete, accurate, straightforward, and consistent with the statutes and regulations of the federal government and well-accepted coding guidelines as established by the Centers for Medicare and Medicaid Services (“CMS”), the American Medical Association (“AMA”), the American Hospital Association (“AHA”), and other relevant professional societies.

几年前,Medicare实施了opps(门诊预期支付系统),支付住院部门提供的服务的医院。该系统包括名为“C-CODES”或“通过”代码的计费代码。Medicare创建了90多个通过类别的设备,并为每个类别提供了自己的C代码(字母“C”,后跟四位数)。如果医院使用属于传递类别的设备,它可以将其提交给Medicare并收到额外付款的条例草案上的适当的C代码。这些通常被称为通过的付款,旨在在两到三年后到期,之后额外付款将折叠到相关的外国支付分类(APC)付款率。

Though the pass-through payments for most C-codes no longer exist, Medicare does require that C-codes continue to be included on hospital claims paid under the OPPS. This is done so that Medicare can adequately capture the resources required to provide services and can use this resource information to establish adequate payment rates in the future. In fact, Medicare has defined certain procedures as being device dependent, and claims for these procedures will be denied if they don’t also include the necessary C-code. Seehttp://www.cms.hhs.gov/hoshitaloutpatientpps.for additional information.