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Thread: Physician coding

  1. #1

    Default Physician coding

    AAPC: Back to School
    Hello ,
    What's the difference between hospital coding & physician coding? Please explain..

    Nalini CPC

  2. #2
    Join Date
    Apr 2007
    Columbia, MO


    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.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Join Date
    Apr 2007
    Lauderdale Lakes


    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

  4. #4


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

    Nalini CPC

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