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outpatient facility coding

  1. #1
    Default outpatient facility coding
    Medical Coding Books
    Anyone out there do this? I am a bit rusty and have a question or two about ICD procedures vs CPT's.
    I have always been under the impression and understanding that outpatient facility uses CPT which correlate to APC's for payment.
    Is there EVER a time you would use ICD procedures on OUTPATIENT facility procedures performed?

  2. Default Outpatient facility coding
    It is usually up to the payer. The encoders that facilities typically use will apply both CPT & Volume 3 codes. However, if a payer does not want the volume 3 codes, they will be removed before releasing the claim. Example: Medicare does not want the volume 3 codes on outpatient claims. Some managed care payers want both CPT & volume 3 codes on the claim.

  3. #3
    Smile ICD-9 Procedure codes
    We use both ICD-9 codes and CPT at our outpatient facility for procedures. The encoder gives both and we submit them to billing that way. I think it is facility specific, but some utilize those codes for tracking purposes and want them entered even though they may not go out on the bill.

  4. #4
    Thanks. I have always used only CPT's on outpatient facility but recently took a test and they apparently only wanted ICD's which wouldn't always be correct anyway. Grrrrr LOL
    Thanks for your replies!

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