Are the cpt procedural coding banned in inpatient billing. Post a Comment. Inpatient coding vs Outpatient coding. Medical coding is broadly divided into two categories inpatient coding and outpatient coding. Here are some of the differences. Outpatient coding involves coding charts where the hospital stay is limited to 24 hours. The patient is treated and discharged within 24 hours.
Outpatient coding is far easier than inpatient coding. In inpatient coding, the patient is admitted and remains in the hospital til he recovers thus making the hospital stay more than one day.
Inpatient Coding: Inpatient refers to a patient who is properly admitted to a hospital upon the orders of the physician who then admits the patient for a long stay. Basics Outpatient refers to a patient who checks into the ER and is being treated but is not admitted to the hospital for a long stay. Coding for Signs and Symptoms If signs and symptoms are a given part of primary diagnosis, they should not be coded in inpatient settings.
Complications If a patient requires an additional length of stay in a hospital due to a complication, the complication should be listed as the principal diagnosis. Coding for Uncertain Diagnoses Uncertain diagnoses should be coded at the time of discharge for inpatient admissions to short-term, long-term, acute care, and psychiatric hospitals.
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Related Articles. August 12, 1, July 21, 2, August 9, December 2, Leave a Reply Cancel reply Your email address will not be published. Check Also Close. However, coders may code up to the absolute degree of certainty.
For example, abnormal test results and unusual signs and symptoms may be coded. If a patient requires additional length of stay in a hospital due to a complication, the complication should be listed as the principle diagnosis. However, if the complication lacks specificity to a diagnosis, an additional code may need to be assigned.
If a patient is admitted to the hospital due to complications during or after outpatient surgery or other outpatient procedures, the complication should be listed as the principle diagnosis for inpatient admission.
However, if inpatient admission after surgery is not a complication, the first-listed reason for the outpatient surgery should be listed. Additionally, if the reason for admission is unrelated to the first-listed reason for surgery, the unrelated condition should be listed as the primary diagnosis in an inpatient setting. The biggest difference between inpatient and outpatient medical coding remains the criteria and instructions for uncertain conditions.
However, coders should always check the guidelines for additional instructions within the tabular and alphabetic indexes. By understanding these key differences between inpatient and outpatient coding techniques, overhead costs in health care settings can be reduced.
A proper understanding will help coders perform more efficiently and accurately in their roles, which is the overall goal of medical coding in the first place. A place for physicians and other healthcare RCM stakeholders to share and discover information about everything related to medical billing and ways to increase revenue. We provide all types of claims billing services integral to healthcare delivery system.
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