Wiki Outpatient Facility Coding Help

[kdietsch85]

I have had my CPC for about 4 years now but have been coding about 7 and I only have experience with professional coding for physicians and NPP's. I'm trying to gain more knowledge regarding outpatient facility coding to broaden by career but I am having trouble finding information regarding coding guidelines etc. for facility coding. I am totally clueless in this regard because like I said I only have professional billing experience, can someone please point me in the direction of where to find information or provide me with a how-to?? What codesets do most facilities use? Do they use ICD-9 and CPT books or a different code set?

 

[awilli68]

I hope you get some good answers to this because I work in an urgent care and we bill by physician but I am going to take the CPC-H because I think it would be more interesting! I'm scared though because I have never done any facility coding! I mostly do billing but we kind of do a little bit of everything since we are pretty small.

 

[jwhite2637]

Hey Kdietsch85,

You'll be happy to know that Outpatient facility coding is almost exactly like outpatient professional coding. You'll still use CPT and ICD-9 codes for pretty much everything you code. The only difference will be the use of G codes and other HCPCS codes that you may not be familiar with from doing professional coding. I'd suggest getting a HCPCS book and looking at a source like Optum for a how to book. Hope this info helps!

 

[kdietsch85]

Hey Kdietsch85,

You'll be happy to know that Outpatient facility coding is almost exactly like outpatient professional coding. You'll still use CPT and ICD-9 codes for pretty much everything you code. The only difference will be the use of G codes and other HCPCS codes that you may not be familiar with from doing professional coding. I'd suggest getting a HCPCS book and looking at a source like Optum for a how to book. Hope this info helps!

Thank you! I will try looking there. We use some Gcodes now where I'm at and some HCPCS but isn't the logic behind assigning particular ICD9 codes a little different? Obviously for professional coding you would apply the result dx rather than presenting symptoms(most of the time).