Inpatient and Outpatient Coding

Inpatient/Outpatient Coding

Differences and guidelines for reporting

Jessica Holman

2/27/2012

In this essay I will discuss the differences between Inpatient and Outpatient Medical Coding. I will also discuss the official guidelines for coding and reporting for outpatient needs and why these guidelines are used.

Inpatient/Outpatient Coding

While researching for this paper I find myself wondering what the difference between Inpatient and Outpatient medical coding is. Medical billing and Coding is divided into 2 categories, Inpatient coding and Outpatient coding. One of the most important aspects of understanding outpatient coding guidelines is understanding how they differ from inpatient coding and guidelines. In this essay I will discuss the differences between inpatient and outpatient coding and the differences between their guidelines.

Medical coding is divided into two categories, Inpatient coding and outpatient coding. Outpatient coding involves coding charts where the hospital stay or office visit is limited to 24hrs, the patient is treated and discharged within 24hrs. Outpatient treatment is where a patient is under observation. Depending on the severity of the patient's illness or the treatment that is required, a patient can go from an outpatient status to an inpatient status. An inpatient status cannot change into an outpatient status that is why it is very important to properly classify a patient. Outpatient medical coders work under a health information manager (www.eicd.com/Guidelines).

As a professional medical coder, you can expect to perform the following duties:

* Assigning codes for the different diagnosis, treatments, and procedures that the health care facility practices using the appropriate codes for outpatient billing.

* Properly coding outpatient treatment of a patient. Outpatient treatment might include diagnostic, therapeutic, emergency department services, ambulatory surgery or same-day surgery, and observation service encounters.

* Finding and entering chargeable items into the billing system for emergency department visits.

* Resolving any errors in the billing process, researching the billing errors for patterns, and suggest changes to prevent future errors.

* Changing daily error reports for any missing or incorrect data elements, and correcting the problem. (www.medicabillingandcoding.org/what-is-outpatient-coding/)

Inpatient coding is performed for more of a hospital setting and often deals with procedures requiring admittance to the hospital. Physicians and hospitals have specific guidelines they must follow to help them decide whether a patient should be classified as an inpatient and be treated in the hospital. As an inpatient coder they to will work under a health information manager. The following tasks are duties that an inpatient coder will be expected to perform on a daily basis:

* Use coding guidelines to assign codes to diagnosis, treatments, and procedures related to the inpatient cases that come into the facility.

* Correctly code an inpatient encounter.

* Properly code the diagnosis