Week 8 DQ 2 HCR230

Week 8 DQ 2 HCR230 - surgery. Both outpatient and inpatient...

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Week 8 DQ 2 HCR230 Yolanda Campos Inpatient is coded when patient is discharge. ICD-9-CM Volumes 1 and 2 is used to code inpatient diagnose and Volume 3 are used for inpatient procedure during hospitalization. When coding there are rules to be followed such as for inpatient hospitalization rule are principal diagnosis is listed first. Example: Inpatient principal diagnosis after surgery: Acute appendicitis (540) Coders for inpatient can also list all condition that have an effect for the patient hospital stay or treatment. Example: Comorbidity: The physician’s discharge summary stated that the patient needed additional care because of chronic obstructive pulmonary disease (COPD) with emphysema. Code: 492.8 UHDDS rules only applies to inpatient service. Outpatient services based on hospital and physician office service are followed by ICD-9- CM Volumes 1 and 2 using outpatient rules and CPT/HCPCS. Medicare and many private payers require precertification for inpatient or outpatient
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Unformatted text preview: surgery. Both outpatient and inpatient facilities must comply with federal and state law. Outpatient services are provided by ambulatory surgical centers or units. The main diagnosis is called the principal other than the primary diagnosis which is established after study in the hospital setting. Coding an unconfirmed condition is (rule-out) as the admitting diagnosis is permitted. A uniform standard can be classification for both inpatient and outpatient coding, such as different spet doing inpatient and outpatient service so they would not get messed up on paper work or coding. Because of the different rules apply to inpatient and outpatient services things can go wrong. Example: Coder can enter the wrong code or switch the rules toward inpatient rules to outpatient rules vice versa. Patient could be paying for wrong treatment or procedure or insurance may not cover service which leads the patient to be responsible....
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