Adrienne Terrell asked:
Hello everyone;
I am confused by inpatient services in the CPT. I am more familiar with the PCS than the CPT book. I was under the impression that once a patient is admitted to hospital then it is no longer an outpatient problem and inpatient coders would use the PCS in that case. What qualifies as an inpatient hospital setting?
Many thanks;
Adrienne
Answer:
PCS is inpatient "facility" procedural coding which you find in your ICD-10 manual. These claims go on UB04 claims. A healthcare provider/physician can admit a patient and do procedures that fall under CPT as the "physician" component and use ICD-10 for diagnosis coding. In physician billing; a physician codes and bills based on the "location". That means; ER; inpatient; outpatient;home; anywhere. A doctor will get more for a procedure in his office based on overhead expenses; etc...if he did the same procedure in an inpatient facility using CMS 1500 claim forms; he would get less money because the facility will bill for services that incorporate the hospital overhead expenses and OR nurses; etc...
Hello everyone;
I am confused by inpatient services in the CPT. I am more familiar with the PCS than the CPT book. I was under the impression that once a patient is admitted to hospital then it is no longer an outpatient problem and inpatient coders would use the PCS in that case. What qualifies as an inpatient hospital setting?
Many thanks;
Adrienne
Answer:
PCS is inpatient "facility" procedural coding which you find in your ICD-10 manual. These claims go on UB04 claims. A healthcare provider/physician can admit a patient and do procedures that fall under CPT as the "physician" component and use ICD-10 for diagnosis coding. In physician billing; a physician codes and bills based on the "location". That means; ER; inpatient; outpatient;home; anywhere. A doctor will get more for a procedure in his office based on overhead expenses; etc...if he did the same procedure in an inpatient facility using CMS 1500 claim forms; he would get less money because the facility will bill for services that incorporate the hospital overhead expenses and OR nurses; etc...
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