Difference Between Outpatient Coding and Inpatient Coding
Table of Contents
Hospital is an institution serving patients in huge numbers daily. Serving to the number of patients and maintaining their record is a must.
Patients requirements and the way he’s diagnosed can be broadly divided into two categories, inpatient and outpatient.
Systematic documentation of the patient belonging to any category between two becomes necessary while billing and coding. There are people employed for this challenging task
The patient’s initial condition before admitting, the diagnosis, and the outcome of the diagnosis hugely varies concerning the patients need and depending on which it’s divided into Outpatient and Inpatient coding.
For the person seeking a career in the medical field and even, it becomes important to understand the difference and opt for a preference at the first. A workplace works differently as per profession and the job one is employed at so the differences help to have an early stage training and development of skills.
Outpatient Coding vs Inpatient Coding
The main difference between Outpatient Coding and Inpatient Coding is the time period a patient stays in the hospital. Outpatient coding is specifically done for patients who are not admitted for a longer time and get departure within 24 hours whereas under the prescription of a doctor the patients admitted for more days are generally handled by the inpatient coders carrying a detailed diagnostic report.
Comparison Table Between Outpatient Coding and Inpatient Coding
| Parameters of Comparison | Outpatient Coding | Inpatient Coding |
|---|---|---|
| Time of stay | Such coding is done specifically for those patients who just come for a checkup and don’t stay for more than a day in the hospital. | The coding is designed concerning the patients to stay, the patient staying for more than 24 hours falls under it. |
| Payment | Outpatient Prospective Payment System (OPPS) provides reimbursement to their respective patients. | The Inpatient Prospective Payment System (IPPS) is the method for the inpatients in accordance with their diagnosis, it’s reimbursement plan by the government and the healthcare providers. |
| Coding System | ICD-10-CM and HCPCS Level II codes are designed to report the details and documentation. | ICD-10-PCS and ICD-10-CM are used to report all the essential data associated with the patient’s stay. |
| Diagnosis | The illness is often not established and defined, in that case, the patient most of the time revisits for further checkup. | The diagnosis is well defined and the requirements and cost can be predefined. |
| Complexity | Outpatient coding is easier and less complex | Inpatient coding goes through the complexity of data arrangement and documentation for as long as the patient is hospitalized. |
What is Outpatient Coding?
Outpatient coding is a kind of medical coding used by the hospital to document the procedures performed and the requirements for the outpatients. it’s detailed reporting.
Outpatients are the people who come to seek direct treatment usually taking a few hours and technically within 24 hours.
The stay of outpatients in the medical facility is less, so is the complexity in the coding, but the same outpatient might frequently re-visit.
The coders seeking a job for outpatient coding require certain qualifications and it’s necessary to have proper knowledge of coding, the most commonly used coding are ICD-10-CM and HCPCS Level II.
It lacks a defined diagnosis that the coding of uncertain diseases is strictly prohibited, the coders can, however, signs and symbols can be used.
What is Inpatient Coding?
Inpatientcoding is the coding system in any medical facility where the detailed analysis and process of diagnosis are listed and documented precisely to ease the overall visit of a patient and of the hospital itself.
Inpatients are those people who are admitted for a longer stay, they are hospitalized for as per the requirements of diagnosis. To classify a person as an inpatient the stay should be more than 24 hours, lasting to furthermore days.
Inpatient coding requires the coder to be pro in both ICD-10-PCS and ICD-10-CM coding systems. They are the basis of the qualification criteria.
The process can be complicated and complex depending upon the stay as prescribed by the doctor. All the facilities like food, medicines, and their data are registered.
Inpatient can claim a reimbursement under Medicare Part A, The Inpatient Prospective Payment System (IPPS) helps in managing and regulating policies.
Main Differences Between Outpatient Coding and Inpatient Coding
Conclusion
Hospitals are an institution of noble people providing healthcare to the vulnerable, they include the doctors, surgeons, nurses, and staff. Each person has a certain essential job to carry out and facilitate the whole process.
Among them are the coders, the outpatient coders, and inpatient coders dealing with every patient visiting for treatment and documenting every step and requirements, they also regulate the reimbursement from medicare
The outpatient coding strictly codes for the patients visiting and leaving within 24 hours, it’s less complex and utilizes the knowledge of codes and guidelines of ICD-10-CM and HCPCS codes.
Inpatient coding is a complex set of documents documenting a patient’s visit and stay for more than 24 hours. It utilizes ICD-10-PCS and ICD-10-CM.coding.
References
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