What is the difference between inpatient coding and outpatient coding?
Coding inpatient and outpatient charts is entirely different taking into consideration CMS rules for prospective payments systems for both inpatient and outpatient coding.
Inpatient coding revolves around DRGs which are the final values generated by using a formula which CMS has proposed. DRG is calculated by taking into consideration the diagnoses codes and the procedure codes. Patients with same DRGs are paid the same amount of dollars irrespective of the disease or procedure they have undergone by CMS.
Inpatient coding does not use CPT for procedural coding instead ICD Volume 3 procedure codes are used to bill the procedure in the inpatient setting.
On the other hand, outpatient coding cases are paid based on CPT codes. Hence an outpatient coder weather he is working for ED or Surgery should be proficient in CPT codes and edits.
One more difference is that inpatient reports are very lengthy and may constitutes thousands of pages whereas outpatient reports or charts are small.
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