Medical Billing and Coding 1
Part A 1. Discuss two differences between inpatient and outpatient coding.
Outpatient coding is much less complicated than inpatient coding. First, outpatient coding is limited to a length of stay less than 24 hours whereas inpatient stays are longer due to the intensity of services. Second, for outpatient services, physicians are paid using CPT/HCPCS codes, whereas, hospitals are paid for their hospitality using a complex formula (MS-DRG) because of housing, feeding and nurturing the patient back to health. During an inpatient stay, the hospital charges based on the amount of time and effort spent on nursing a patient back to health so when it comes to normal birth vs an operation for an elderly person, the hospital will charge based on the severity of the patient’s illness.
When it comes to inpatient coding, coders have to be very attentive in order to correctly code the reason for the principal diagnosis because it is crucial to the MS-DRG formula. As for the outpatient coding, the first listed diagnostic code indicates the reason for the encounter. In conclusion, the outpatient coding summarizes all diagnoses and typically includes a single procedure whereas inpatient coding requires daily coding of each service on each day of hospitalization. 2. CPT Code: 21931
ICD-9-CM Code: 239.2 not correct
3. Discuss coding for obstetrics, including items covered by the global fee for antepartum and postpartum periods of normal pregnancy.
Global coding for obstetrics is basically for the services and supplies needed for the antepartum, delivery, and postpartum period of a normal pregnancy. The antepartum period of pregnancy is the time of pregnancy from conception to the onset of delivery. The initial and subsequent history, all physical examinations, recording of blood pressure, weight, fetal heart tones, routine urinalysis, and monthly visits up to 28 weeks gestation are included in antepartum care. After 28 weeks, biweekly visits up to 36 weeks
Outpatient coding is much less complicated than inpatient coding. First, outpatient coding is limited to a length of stay less than 24 hours whereas inpatient stays are longer due to the intensity of services. Second, for outpatient services, physicians are paid using CPT/HCPCS codes, whereas, hospitals are paid for their hospitality using a complex formula (MS-DRG) because of housing, feeding and nurturing the patient back to health. During an inpatient stay, the hospital charges based on the amount of time and effort spent on nursing a patient back to health so when it comes to normal birth vs an operation for an elderly person, the hospital will charge based on the severity of the patient’s illness.
When it comes to inpatient coding, coders have to be very attentive in order to correctly code the reason for the principal diagnosis because it is crucial to the MS-DRG formula. As for the outpatient coding, the first listed diagnostic code indicates the reason for the encounter. In conclusion, the outpatient coding summarizes all diagnoses and typically includes a single procedure whereas inpatient coding requires daily coding of each service on each day of hospitalization. 2. CPT Code: 21931
ICD-9-CM Code: 239.2 not correct
3. Discuss coding for obstetrics, including items covered by the global fee for antepartum and postpartum periods of normal pregnancy.
Global coding for obstetrics is basically for the services and supplies needed for the antepartum, delivery, and postpartum period of a normal pregnancy. The antepartum period of pregnancy is the time of pregnancy from conception to the onset of delivery. The initial and subsequent history, all physical examinations, recording of blood pressure, weight, fetal heart tones, routine urinalysis, and monthly visits up to 28 weeks gestation are included in antepartum care. After 28 weeks, biweekly visits up to 36 weeks