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.

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.

Facility’s schedule for the performance of elective surgical procedures on patients admitted and discharged on the same day the procedure is performed.

Evaluation and analysis of the medical necessity, appropriateness, and efficiency of medical services given in an ambulatory facility. Utilization review is typically performed by a utilization review committee.

AVGs were replaced by ambulatory patient groups (APGs) as an outpatient classification system by Health Systems International (HSI). Then ambulatory surgery categories (ASCs) were adopted, replacing 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.

Under HIPAA’s final privacy rule, an amendment to a patient’s medical record indicates that the data are in dispute while retaining the original information, while a correction to a medical record alters or replaces the original record.

National organization that was formed as a result of a merger of the Health Insurance Association of America (HIAA), Group Health Association of America (GHAA), American Managed Care and Review Association (AMCRA), and American Association of Health Plans (AAHP). Their member companies offer insurance coverage for medical expenses, long-term care, disability income, dental, supplemental, stop-loss, and reinsurance to consumers, employers, and public purchasers. Its purpose is to represent the interests of their members on legislative and regulatory issues at the federal and state levels, and with the media, consumers, and employers. They provide information and services such as newsletters, publications, a magazine, and on-line services. They also conduct education, research, and quality assurance programs and engage in a host of other activities to assist their members. AHIP participates in the maintenance of some code sets including the HCPCS Level II codes.