See: aggregated diagnosis groups (ADGs).
Tag: MEDICAL
Ambulatory patient
Individual who is receiving medical services and is able to walk or ambulate in a wheelchair.
Ambulatory patient care groups
See: ambulatory payment classification (APC) system.
Ambulatory patient groups (APGs)
Classification system by case types used until 2000 as a payment method developed for the Centers for Medicare and Medicaid Services (CMS). It was replaced with ambulatory surgery categories (ASCs) and later replaced by the ambulatory payment classification (APC) system.
Ambulatory payment classes
See: ambulatory payment classification (APC) system.
Ambulatory payment classification (APC) system
1. Method developed by the Centers for Medicare and Medicaid Services (CMS) for outpatient hospital reimbursement based on procedures that have similar clinical characteristics and similar costs rather than on diagnoses. 2. Medicare’s outpatient prospective payment system (OPPS) for hospital outpatient services that became effective August 1, 2000. Depending on the services given, hospital facilities may be paid for more than one APC for an encounter. APC information is updated and released twice a year in the Federal Register. Also called ambulatory payment classes, ambulatory patient classifications (APCs), and ambulatory patient care groups.
Ambulatory payment classifications (APCs)
See: ambulatory payment classification (APC) system.
Ambulatory surgery
Operative procedure performed on a patient as an outpatient in which he or she is admitted, treated, and released on the same day from the facility. Also referred to as outpatient surgery.
Ambulatory surgery categories (ASCs)
ASCs were adopted to replace ambulatory patient groups (APGs) for outpatient or 1-day surgery cases that were derived from the surgery section of the CPT. Later, this was replaced by the ambulatory payment classification (APC) system.
Ambulatory surgery center (ASC)
Licensed freestanding facility, other than a physician’s office, at which outpatient medical services are provided on an ambulatory basis (e.g., diagnosis, treatment, same-day surgery, rehabilitation). ASCs are hospital based (or sponsored) or independently owned (or sponsored). Surgery of an uncomplicated nature that traditionally was done on an inpatient basis but can be performed with equal efficiency without hospital admission is now being done in an ASC. To receive payment for Medicare patients, the facility must have an agreement with the Centers for Medicare and Medicaid Services (CMS) and meet specific requirements. ASCs are paid according to nine different payment groups based only on their cost similarities. Also called surgicenter or ambulatory surgical center.