Reader Question: Packaging Services

Question: Im confused about what is and isnt packaged under APCs. Ive heard that HCFA says that ancillary services that are directly related to or part of the primary service performed will be packaged into an APC. What does this mean?

Ohio Subscriber

Answer: HCFA states that services such as operating and recovery room use, anesthesia and supplies and equipment for administering anesthesia are included in the related APC. In most situations the costs of drugs, devices and biologicals are also included in the APC rate, except for those that are on the pass-through list.

There are several exceptions to the packaging rule. These exceptions have their own APC groups, which make it possible for a separate payment for these services. Some services that arent packaged are: casting, splinting and strapping; immunosuppressive drugs used after organ transplant; corneal tissue acquisition costs; blood and blood products; and the occasional high-cost drugs that are rarely used and are not on the pass-through list.

- Published on 2001-03-01