Understanding Outpatient Coding and Reporting

doctor patient with outpatient medical recordsThere are a great number of opportunities in the Health Information Management are that can save your practice or hospital valuable resources. Outsourcing your inpatient and outpatient medical coding are just 2 instances that streamline your facility. But what is medical coding? What is the difference between Inpatient and Outpatient coding? If the terms sound a little futuristic for you, good! Because in the Health Information Management field, the future is here!


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Not many people even know about the medical coding profession. But it is a necessary process that every doctor’s office and every hospital must complete in order to bill insurance companies for payments.

Sometimes it is called medical classification or medical coding. In the process, information is taken from a variety of different sources, including health records, descriptions of physician’s notes, lab results, radiology results and other sources. The diagnoses codes are used to track various diseases and health conditions.

In the Health Information Management field there are two types of medical coding. One is outpatient coding, which is used by clinics, physician offices, hospital emergency rooms and ambulatory centers. And with outpatient coding, treatment of the person is done on that same day.

With inpatient coding, you’re dealing almost exclusively with acute care facilities. Inpatient coding is done when a patient has been admitted to that type of facility for longer than 24 hours.

Can you become a medical coder? Sure. What you will need to learn from a coding perspective is determined by the difference between inpatient and outpatient coding.

Outpatient Coding Credentials:

For outpatient coding credentials, our medical coders have an AHIMA certification as a Certified Coding Specialist – Physician-based (CCS-P).

Our medical coders keep up with:

  • ICD-10, International Classification of Diseases. Latest Version: 2010.
  • CPT – Current Procedural Terminology (CPT®) which are developed by the American Medical Association and first published in 1966. They are a listing of standardized descriptions and five-character, alphanumeric codes that medical coders and billers use to report health care services and procedures to provide payers for reimbursement.
  • HCPCS – Healthcare Common Procedure Coding System (HCPCS) code set.

Inpatient Coding Credentials:

For inpatient coding credentials, our medical coders have an AHIMA certification as a Certified Coding Specialist (CCS).

Like our outpatient medical coders, our inpatient coding specialists are skilled in:

    • ICD-10, International Classification of Diseases.
    • DRG classification system. It is organized by major diagnostic category (MDC) and is a reference for those who need to verify DRG information and accurately assign MS-DRGs concurrently or retrospectively.

Finally, it is important to realize that, whether inpatient or outpatient coding, you need a medical coding company with a mastery the official coding guidelines released by the US Dept. of Health and Human Services!