Question can someone give me list of all inpatient conditions/ diagnosis which can not be coded in outpatient coding?????

thomas7331

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There is no such list that I'm aware of - I can't think of any condition that would only ever be coded for an inpatient. If there is, it may be specific to a particular payer. Medicare, for example, does have a list of surgical CPT codes that they will not reimburse to a facility on an outpatient claim, but that is their own coverage requirement and does not mean that the codes may not be used for outpatient coding.
 

sls314

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CMS has a list of inpatient only procedures, but there isn't a list of inpatient only diagnosis codes.
 
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The best rule of thumb to use is, acute conditions that risk adjust should not be pulled from an outpatient note, unless there is documentation of sending the patient to ER or direct admitting the patient. Ex. MI, CVA
 
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