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Coding inpatient vs outpatient

Leigh Posted Tue 03rd of January, 2012 22:48:50 PM

Example: A patient is an inpatient at one facility- for 10 days- but on the 5th day they are transferred to another facility for an interventional procedure that can only be done there, then they are transferred back to the original facility the same day.

My question is would all the charges be coded as POS "inpatient"- including the ones done at the other facility?

The 2nd facility's charges are coming to us as POS "outpatient".

SuperCoder Answered Thu 05th of January, 2012 14:41:30 PM

If the surgery done at other facility is billed with POS as "outpatient", then the other services provided at the other services should also be billed as "outpatient" (I presume it is an ASC or if any other hospital, then I presume all services provided at outpatient setting) thus reflecting the correct level of service provided to the patient.

Leigh Posted Thu 05th of January, 2012 18:09:42 PM

All charges done at 1ST FACILITY are coded as inpatient... then the surgical procedure done at the 2ND FACILITY---in the middle of the 1ST FACILITY'S inpatient stay--is coded as outpatient.

I'm trying to figure out if that is correct

or

If the charges at FACILITY 2 should also be coded as inpatient.

Sorry if this is confusing.

SuperCoder Answered Thu 05th of January, 2012 19:14:00 PM

Laura, The interventional procedure should be coded as outpatient and yours as inpatient. This makes sense the patient is an inpatient but had to go to interventional radiology surgery center to have same-day services and then return to your facility for overnight inpatient care.

Jen Godreau, CPC, CPMA, CPEDC
Director, SuperCoder.com

Leigh Posted Thu 05th of January, 2012 19:36:16 PM

Thank you so much!

We only charge the professional (mod 26) part of the procedure (as the reading radiologist)... would this stand true for the professional charges only.

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