10 tips for avoiding APC traps

To encourage proper payment and avoid imposition of penalties by the Office of Inspector General, providers need to prioritize outpatient compliance efforts. Departments should be accountable for reconciling outpatient code editor edit failures. Evaluation and management code assignment should be examined for inter-rater reliability. Transitional pass-through items should be audited routinely; associated coding should be kept current. Consideration should be given to meeting medical necessity requirements, particularly for mental health services.