Wiki Hospital Outpatient Clinic Coding

[srhinesmith]

Hello...this is my first time participating in an AAPC forum so be patient with me! Our clinic is very similar to a dialysis clinic...we are an artificial pancreas treatment (IV insulin therapy). Currently, we have clinics around the U.S. which are freestanding. We are toying around with the idea of having outpatient clinics in hospitals. We do not code for hospitals and would like advice as to how to code properly for this. Currently, we use the following codes: 99213, 82948, 82962, 94681, 96365, 96367, 96374, 96375, 96521. Any help would be greatly appreciated!

 

[CBarton]

Have you received the correct code to use in this case?

 

[am302569@yahoo.com]

i am looking for the same information, if anything is found please share.

 

[lmartien]

Hello, I've been in the hospital outpatient clinic arena for several years. You should be able to code and bill for any of the same procedures/services as you do now. You will need to become familiar with the UB-04 claim form, which includes things like occurrence and value codes, as well as revenue codes. I have found the Uniform Billing Editor to be a great resource! E/M services are captured differently as facilities cannot evaluate or manage an encounter. Instead they capture the overhead to perform the procedure/service (sometimes called the "lights on" value). There are several tools used to level E/M services out there. Most facilities have developed their own.
Please don't hesitate to reach out to me if you have further questions.