The medical coding practice is divided into two main domains: inpatient coding and outpatient coding.
For an aspiring medical coder, it’s vital to understand the differences between these two coding domains and set a preference from an early stage. This will help them focus their training and education accordingly and spend more time learning about the domain that they are interested in.
So what exactly are inpatient and outpatient coding and how are the two coding domains different from each other?
What is Inpatient Coding?
Inpatient coding is a type of medical coding used for reporting services that are performed on inpatients.
Who are inpatients?
Inpatients are those patients who have been officially admitted to the hospital under a physician’s order.
It must be noted that for a patient to be classified as an inpatient, the patient must spend more than 24 hours at the hospital. Patients admitted to a hospital for 24 hours or less are not classified as inpatients.
During their stay, the patient will be charged for all the services and facilities they use and will be billed accordingly. Since such stays are long, they result in creation of patient records that are quite extensive and intricate. This makes inpatient coding complex and detail intensive.
What is Outpatient Coding?
Outpatient coding is a type of medical coding used for reporting health services availed by outpatients
Who are outpatients?
Outpatients are patients who visit a hospital for treatment but are not admitted. These patients may stay at the hospital for few hours or even overnight.
Since outpatient visits are brief, outpatient coding is relatively less complex than inpatient coding.
What’s the difference in the coding schemes for the two medical coding domains?
Inpatient coding utilizes ICD-10-CM and ICD-10-PCS codes to transcribe the details of a patient’s visit and stay. Outpatient coding on the other hand utilizes ICD-10-CM and HCPCS Level II codes to report health services.
Reimbursements for both types of services are requested under the Medicare program. Inpatient claims are processed under Medicare Part A while outpatient claims are paid under Medicare Part B plan.
In the end, no matter which type of coding domain an aspiring coder may choose to specialize in, they both have their individual importance in the healthcare reimbursement cycle, and both require the same level of commitment and dedication from medical coders.
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