APC codes

Hospital-Based Outpatient Clinics The Outpatient Prospective Payment System (OPPS) is the method for compensation for hospital-based outpatient facilities (DHHS, 2000a). With this system, there is a professional component (e.g., for physician providers) and a technical component (e.g., for nonphysician health care professionals) to billing that describes the various contributions of the health care team during the specific patient encounter. Ambulatory Payment Classification (APC) codes are used within this system to describe the type and complexity of the patient visit to the insurance company. When pharmacists provide services within a hospital-based clinic, the compensation for the service goes to the hospital facility instead of directly to the provider. The revenue generated should be able to be tracked internally as to which department or health care professional was involved in the care of the patient (Snella and Sachdev,... 

Fig. 8. Coding of the two rf signals, which generate a slowly rotating rf field vector B2 in the laboratory xy-plane. mark time intervals for APC. (Ref. 45)...

A counterbalance to the positive roles that pharmacists play is the increase in the amount of time that we spend on reimbursement and payment issues. Pharmacists in ambulatory care play a role in adjudication of third party claims and often bring the news to patients that a drug ordered for them is not covered by their pharmacy benefit. This often places us in conflict with the patient and their physician in a system that is not our creation. The difficult financial condition of many hospifals places the pharmacist in roles of assuring reimbursemenf for pharmaceuticals for both inpatient and ambulatory care. The Ambulatory Payment Classification (APC) system is intricate and terribly complex and pharmacists must be directly involved in some aspect of fhe coding to assure paymenf. These roles do not represent the optimal use of our scarce manpower. 

Fig. 12. Amino acid sequence of the three biliproteins from the phycobilisome of the cyanobacterium M. laminosus (Fischerella PCC 7603) a/3-APC, a/3-C-PC, a/3-PEC and of C-PE from the cyanobacterium Fremyella diplosiphon (Calothrix UTEX 481). [PEB] is the phycoerythrobilin chromophore of C-PE the PCB-chromophores of a/8-APC, a/3-C-PC and -PEC and the PXB-chromophore of a-PEC are bound at homologous positions (to Cys and to Cys" ) and are not shown. The names of the amino acids are abbreviated according to the one-letter code (Eur. J. Biochem. (1983) 183, 9-33).

This chapter will focus on mutations in genes that code for proteins called APC, RAS, p53, and cadherin. RAS is pronounced "rass." The name "p53" arose because it is a protein (p) with a molecular weight of 53 kDa. These proteins have vital and useful functions In the... 

Most of the mutations in human APC have been found to result in the conversion of CGA (cytosine-guanine-adenine), which codes for arginine, to TGA (thymino uanine-adenine), which is a stop codon (Polakis, 1997). The stop codons in mRNA (UA A, UAG, and UGA) act as a signal during translation that halts polypeptideformationatthatpoint.Theresultis synthesis of a tru nca ted polypeptide. All types of mRNA contain stop codons hovt ever, if a mutation results in the appearance of a stop codon in a new location, then transcription will stop at that new location. 

Three-alternative forced choice (3-APC) The test allows to determine if two products differ in the specified dimension and which sample is higher in perceived intensity of the specified attribute. Three coded samples (two of which are the same and one is different) are distributed between the panelists in randomized or balanced order in three possible combinations (AAB, ABA, BAA, or BBA, BAB, ABB). As for the triangle the null hypothesis is P = 1/3. 

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