Preview

Hca/230 Inpatient and Outpatient

Good Essays
Open Document
Open Document
354 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Hca/230 Inpatient and Outpatient
What are the major differences between inpatient and outpatient hospital services? Describe how these differences affect the coding process and provide examples.

There are some differences between the outpatient and inpatient services offered by the hospitals. The inpatient services deal with services provided in the form of overnight care provided to the patients. These services can be under different care units depending upon the needs of the patients. Example of some of these care units can be long term care facility and the skilled nursing facilities. Contrary to it the outpatient services offered by the hospital constitute of emergency services performed in the emergency departments of the hospital. Besides the emergency services there is another care unit called the ‘ambulatory outpatient care unit’. In the patients are admitted as an outpatient but they do not stay overnight and go home the same day after they have been administered with the required medical procedure and treatment. Hospice and home health care also fall under the category of the outpatient services.
Since the services offered in the outpatient and the inpatient is different hence there is a difference in the coding process also. In case of an inpatient service the coding is done when the patient is discharged and the rules for the application of codes in the inpatient services are a bit different than in the outpatient services. The most major difference is that the outpatient services use the primary codes and the inpatienservices use the principal codes. Also in case of inpatient services the codes may be different at the time of admitting the patient and at the time of diagnosis. Example would be like code 789 is used as an admitting code for the severe abdominal pain and after diagnosis code 540 would be used for acute appendicitis.

In the inpatient coding the ICD codes are utilized whereas in the outpatient coding the CPT codes are utilized. Also contrary to as stated above

You May Also Find These Documents Helpful

  • Satisfactory Essays

    The Medicare National Correct Coding Initiative effects the billing and coding process in many ways. This organization was established to prevent improper coding and billing. The benefits of the CCI, is it performs audits that catch most of the improper coding. It detects codes that should not be coded together, which could cause the patient to be double billed, or improperly billed. The system stops the physician from billing the patient until the codes are properly…

    • 268 Words
    • 1 Page
    Satisfactory Essays
  • Satisfactory Essays

    E/M Codes Analysis

    • 160 Words
    • 1 Page

    A negative impact for not correctly assigning these codes , would be denial for payment of services rendered . Which in turn will cause the physician and facilities to lose massive amounts of money.…

    • 160 Words
    • 1 Page
    Satisfactory Essays
  • Better Essays

    Many RHITs use universal coding systems to assign diagnostic and procedural codes to each piece of patient information. This allows…

    • 883 Words
    • 4 Pages
    Better Essays
  • Satisfactory Essays

    Describing Cpt Modifiers

    • 333 Words
    • 2 Pages

    The CPT codes have three categories, starting with Category I, then Category II, and Category III. There are key words associated with these three code categories which include “common,” “optional,” and “temporary,” these key words help to make the coding process easier for employees to understand. Common codes are referred to when using Category I codes, because this category of codes is the most widely used throughout any medical practice. Category II codes are optional codes and Category III codes are known as temporary codes.…

    • 333 Words
    • 2 Pages
    Satisfactory Essays
  • Satisfactory Essays

    Category I codes are always procedure codes. They are codes which exist for any and all types of procedures that are done within our facility. It does not matter what the procedure is that is completed, there will always be a particular code to coincide with it. One example of a category I code would be 96360. This is the code used for intravenous infusion and hydration- initial, 31 minutes to 1 hour in length.…

    • 337 Words
    • 2 Pages
    Satisfactory Essays
  • Satisfactory Essays

    Hcr Week 5

    • 383 Words
    • 2 Pages

    Optional – Category II codes are optional codes that can be used to track performance of a patient. This could be performance of losing weight, quick smoking, maintaining blood sugar levels. This is just a few things that a doctor may track. These codes are not paid for my insurance companies and do not control patient care – therefore these codes are optional for doctors to use.…

    • 383 Words
    • 2 Pages
    Satisfactory Essays
  • Better Essays

    This book of codes was developed by the World Health Organization and is used in the United States to code diseases and procedures. The ICD-9 is considered a federal document and can be used freely. It is updated annually and plays a major role in the reimbursement to hospitals. Since 1983, the ICD-9 has been used for determining diagnostic- related groups to which a patient is assigned. The ICD-9 has no copyright (Wager, Lee, & Glaser, 2009).…

    • 876 Words
    • 4 Pages
    Better Essays
  • Good Essays

    John is a Medicaid patient suffering from high blood pressure whose father recently had a heart attack. His recent search for a Medicaid provider within his area has left him on the outskirts of accessible healthcare and has decreased his utilization. His closest primary care provider is forty minutes away and he has to make his appointment two weeks in advance.…

    • 1052 Words
    • 5 Pages
    Good Essays
  • Satisfactory Essays

    Practice - form the backbone of ambulatory care. b. Hospital outpatient clinics - function as the community safe net. c. freestanding facilities - walk in clinics b. Mobile facilities - provide certain types of health service d. Telephone triage- expert opinion and advice. f. Home care - service bought to people at home. g. hospice care -a cluster of comprehensive services. H. outpatient long term care -provide coordination and complements informal care. I. Public services -care of patients. j. Community health - provide family orientation and preventive care. Alternative clinics - including wide range of treatments.…

    • 286 Words
    • 1 Page
    Satisfactory Essays
  • Satisfactory Essays

    These codes are optional; they are not paid by insurance carriers. They help in the development of best practices for care and improve documentation. These codes have alphabetic characters for the fifth digit:…

    • 440 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    Out patient care is care that is provided to individuals that can come and go (no over night stays). Out patient care is for people that need assistance with things such as physical therapy, speech therapy, as well as occupational therapy. Other types of outpatient care are chemotherapy centers, pain management centers and dialysis.…

    • 554 Words
    • 2 Pages
    Good Essays
  • Satisfactory Essays

    When people think about jobs in the health care field, it can be easy to assume that most jobs involve direct, hands-on patient care. What many people don’t realize is that administrative jobs are equally vital to ensuring quality health care services. Medical billing and coding is an important piece in the administrative puzzle that makes up the vast health industry. As with most administrative jobs, medical coding and billing professionals need to have excellent attention to detail, as one wrong code or inaccurate statement can have an extremely negative impact on a health care facility.…

    • 612 Words
    • 3 Pages
    Satisfactory Essays
  • Good Essays

    Continuity of care, for all patients, depends on the medical professionals working together for the betterment human health that frequently rely on each other to completely care for the patient. I don’t believe one could distinguish who or what department is more important in the care of a patient in the hospital setting; from the emergency department entrance door spanning throughout the hospital, every department and every medical professional is focused on one goal: to restore normalcy in the patient and return he/she to the life that he/she was living prior to entering that door. Patient care is conquered by a team of providers contributing to a plan of care for the stabilization, improvement, and health of human…

    • 315 Words
    • 2 Pages
    Good Essays
  • Good Essays

    Thousands and thousands of codes were added to ICD-10 compared to ICD-9. This new change is for a very important reason, improvement of quality of care for the patients, among other reasons as well (Freed Associates, 2016). First, ICD-10 codes provide nurses, physicians, etc. with more options with more detailed codes so they don’t have to modify as often and really get all the information across with just one specific code. With this change, it improves patient and public health tracking, they can now see more detailed information of a patient’s progression or even an overall public disease. They also can provide more detailed information on accidents and injuries, such as where they happened, and what injuries the patient suffered from.…

    • 325 Words
    • 2 Pages
    Good Essays
  • Good Essays

    Shouldice Hospital

    • 1505 Words
    • 7 Pages

    Q1: How does shouldice compete? In other words why do patients come to shouldice hospital?…

    • 1505 Words
    • 7 Pages
    Good Essays

Related Topics