Wiki Physician coding

[NaliniAAPC]

Hello ,
What's the difference between hospital coding & physician coding? Please explain..

Thanks,
Nalini CPC

 

[mitchellde]

I am not sure what you are looking for but I will start with this:
Hospital coding is for the facility reimbursement either inpatient or outpatient. Inpatient is based on DRGS and outpatient is based on APCS if it is acute care. A hospital may be designated as Acute care, FQHC, Rural Health, Indian Health, Critical Access, ASC, Nursing facility, and Hospice and I may have left out a few. Hospitals bill on a UB-04.
Physician coding is for the physician or NPP reimbursement and is based on POS and is billed on a CMS 1500.

 

[tpontillo]

Also in inpatient coding they are using the ICD-9-cm volume 3 for the procedure coding. They dont use the CPT book. Also some of the rules are a little different. For example. For inpatient the doctor is ruling out diabetes, you would code the diabetes code, for outpatient you are not allowed to code this. Hope this helps

 

[NaliniAAPC]

Hi,
Thank you very much for your valuble response both Debra and Tpontillo.
I got an clear idea about Physician and Hospital coding...

Thanks
Nalini CPC