Wiki Am I coding inpatient or outpatient?

Victoria323

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If im coding for the providers services and entering in just icd 10 cm- but see the patient is inpatient or the EM service is an inpatient code- am I technically coding inpatient?

In my screen, EPIC is only showing the option to enter icd 10-cm and I’ve read that you enter pcs during inpatient. So I’m confused. What’s the difference and when should I be entering pcs codes?

I only have Aapc’s Cpc training and they didn’t really cover this. I have an interview coming up with another facility and I just want to be prepared if they ask me if I have inpatient coding experience- would I even say yes? I’m very confused and obviously too embarrassed to ask my coworkers/manager.
 
no problem, it can be confusing. ICD-10 Cm is used for diagnosis coding for physician services, clinic visits, inpatient visits, or outpatient. It is also used for diagnosis coding by the facility for their inpatient or outpatient claims.
CPT coding is used by providers for all of their services they provide for the patient, in the office or facility , the facility will use CPT codes for outpatient services they provide.
ICD-10 PCS codes are used by the facility for all inpatient services provided to the patient.
So if you are a Pro fee coder you will use ICD-10 CM code for the diagnosis and CPT code for the services provided such as E&M, regardless of setting.
If you are a facility coder you will use ICD-10 CM codes for the diagnosis wheter inpatient or outpatient, and ICD-10 PCS codes if you are coding inpatient services (surgeries mainly), or CPT codes if you are coding outpatient services.
I hope that helps clarify a little bit
 
Ok so I am coding pro fee inpatient and outpatient?

I would only use PCS if I’m coding for the facility and it’s for the inpatient procedure- correct? I would still use CM for my dx or if I’m coding outpatient for the facility I then go back to CPT instead of PCS (for the procedure) and still code CM for my diagnosis- correct?
 
Yes it sounds like you are a profee coder for both inpatient and clinic visits. you will always use ICD-10 CM codes for the diagnosis and CPT for E&M and procedures. You will never need to worry with ICD-10 PCS codes until you decide to work for the facility
 
Hello Victoria,

Much like myself I am a profee coder capturing charges for Internal Medicine providers who treat patients while admitted to observation or as inpatients nonetheless the this is an outpatient arena I only capture using Dxs and CPT codes. Glad you got an answer.
 
Hi David, I interviewed for an inpatient E/M coder- they said its just icd 10 and cpt --- do you think its just different verbiage regarding the inpatient and outpatient coding?
 
I am having the hardest time understanding where Pro Fee coding is used. I've been told it's used in both inpatient and out. I read many different definitions of it. Can someone provide accurate information/website. I've been turned down by many employers because I don't have "profee"coding. I've only coded hospital outpatient services including Imaging, ED and GI surgeries.
 
I am having the hardest time understanding where Pro Fee coding is used. I've been told it's used in both inpatient and out. I read many different definitions of it. Can someone provide accurate information/website. I've been turned down by many employers because I don't have "profee"coding. I've only coded hospital outpatient services including Imaging, ED and GI surgeries.

Pro Fee is short for professional fees.

Essentially, physician coding. (Could also encompass any nurse practitioners and physician assistants that work in the office with the physician.)

Whether the service was rendered on an inpatient or outpatient basis, the pro fee coder would code the physician records for that service that would ultimately get billed out on a CMS-1500 form.

It sounds like you were coding from facility records, and the services ultimately would have been billed out on a UB-04.

If you're interested in pro fee coding, I think there's certainly a way to market your existing skills on a resume for pro fee positions. Sarah Ragan would probably be a great person to talk with about that - she's really good about taking someone's experience and strengths, and framing them the right way on a resume.
 
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