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Wiki OPPS /APC question

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S

sahni.vani@gmail.com

Networker
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Location
Olney, MD
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Hi All- One of code didn't deny but adjusted the payment. The explanation for denial is that it's not reimbursable based on OPPS but by FS or other payment system. They also mentioned it was priced based on APC grouper amount. Codes J0585 ( Adjusted amount ) with 95873 and 64642 ( paid). My question is what does explanation means and How does OPPS and APC differs ? Thanks Vani
 
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