Medical Coding Inpatient vs. Outpatient Coding

Medical Coding Inpatient vs. Outpatient Coding
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Q: I’m having a tough time distinguishing between how coding is done for each side (Inpatient vs Outpatient). Are we coding whatever, (e.g. Indications & Signs) in outpatient and simply the definitive medical diagnosis on the inpatient, or do I have them puzzled?

A: So, yes, it’s a little bit confusing. I wished to deal with 2 problems with this concern. One, do we code for symptoms and signs plus the definitive medical diagnosis? And 2, can outpatient coders code rule out diagnosis?

Let’s take a look at the first one– Coding Indications and Signs. This applies to inpatient and outpatient, so that’s the first response to the concern there. I went to different experts and they were trying to rule out multiple sclerosis, MS.

As it ended up, after everything was said and done, I had a complex migraine. My neck needed to be changed or whatever and after a few chiropractic treatments, I was great. However it was quite frightening because when you work, I was a physical therapist, and I dealt with stroke patients and you start seeing those signs, you get really scared. So, they did an eliminate. I did all these tests and laboratories and MRIs to eliminate multiple sclerosis. My symptoms and signs were the tingling and the weak point and all those other things. So, the definitive diagnosis, had I been diagnose with it would have been numerous sclerosis. In the end, my definitive diagnosis was complicated migraines. OK? So, that’s what conclusive means.

Now, when you’re handling indications or symptoms as whether or not you code both, the indications and the symptoms and the conclusive diagnosis, depends on whether that sign or symptom is thought about integral to that disease. If you constantly have one with the other, then you do not code the indication or sign, OK?

Here’s an example: Client comes in with wheezing and they’re identified with asthma. Well, wheezing always accompanies asthma, but you would not code the wheezing, you would simply code the asthma. There are lots of other examples out there, but that’s a pretty good one.

Learn more here:
https://www.cco.us/medical-coding-inpatient-vs-outpatient-video/

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