How Does Coding for Inpatient Differ from Outpatient Coding?
Medical coding turns healthcare services into standardized codes for billing. If you’re considering a career in medical coding, it’s important to understand the difference between inpatient and outpatient coding.
Coding Systems
Inpatient Coding uses ICD-10-CM for diagnoses and ICD-10-PCS for procedures performed during hospital stays.
Outpatient Coding uses ICD-10-CM for diagnoses and CPT/HCPCS codes for procedures and services provided during clinic visits or same-day services.
Main Differences
Inpatient Coding:
- Covers the entire hospital stay
- Includes all diagnoses and procedures from admission to discharge
- Requires understanding complex medical conditions and their relationships
- Uses the MS-DRG system for payment
Outpatient Coding:
- Focuses on single visits or encounters
- Codes only what happened during that specific visit
- Generally less complex but requires attention to detail
- Uses different payment systems like APCs or fee schedules
Documentation
Inpatient Coders review many documents, including:
- Admission notes
- Progress notes
- Consultation reports
- Discharge summaries
Outpatient Coders typically review fewer documents, mainly:
- Provider’s notes for a specific visit
- Any test or procedure reports from that visit
Certifications
Inpatient Coding: Often requires the CCS (Certified Coding Specialist) certification
Outpatient Coding: Often requires the CPC (Certified Professional Coder) certification
Many coders start with outpatient coding and move to inpatient coding as they gain experience. Both fields offer good job opportunities in healthcare.
Do you want to become a qualified coder? National Science College’s program can get you over the finish line.