Running head: INPATIENT AND OUTPATIENT HOSPITAL SERVICES

Inpatient and Outpatient Hospital Services HCR230

INPATIANT AND OUTPATIENT HOSPITAL SERVICES

Inpatient and Outpatient Hospital Services Inpatient services are overnight stays in hospitals and start with admission which includes insurance verification, securing consent, and collecting advance payments. Inpatient coding includes procedures under a physicians care such as intravenous injections, feeding tubes, and changing of sterile dressings. Discharge from the hospital or transfer to another facility starts the coding process, medical records compilation, claims and billing creation. Inpatient coding is different in that it is done in certain time frame. The Coding Clinic ICD-9-CM, Volume 1 & 2 are assigned to inpatient diagnosis and Volume 3 codes for hospital procedures. Inpatient codes list the principal diagnosis first which is the reason for admission. An example would be admitting reason severe abdominal pain code (789.00), but after surgery code acute appendicitis (540). Inpatient coding can also include complication codes such as hypertension 402.90 or comorbidity 492.8 (Valerius, Bayes, Newby, & Seggern, 2008). Outpatient services are same-day treatment such as emergency room treatment, but there is an increase with hospitals expanding to outpatient care. Same-day surgery can be performed in a separate part of a hospital called an ambulatory surgical unit or a free standing facility called an ambulatory surgical unit. The patient proceeds to their procedures where each department provides the charges. Outpatient services also include home health care, such as physical therapy or skilled nursing care for at-home recovery care or hospice care for terminally ill. Outpatient Prospective Payment System (OPPS) was authorized by the Balanced Budget Act of 1997 (Valerius, Bayes, Newby, & Seggern, 2008).

INPATIANT AND OUTPATIENT HOSPITAL SERVICES

Reference Valerius, J., Bayes, N., Newby, C., & Seggern, J. (2008). Medical insurance: An integrated claims process approach (3rd ed.). Boston, MA: McGraw-Hill.