Resolved PCS or CPT

[VikramM_80891]

I have a procedure/operative report. How do I identify that I should code procedures utilizing ICD-10-PCS codes (Inpatient), or CPT Codes (Outpatient) ? (What all would be the indications in the report to differentiate/identify inpatient/outpatient.) Dear Members, Please suggest.

 

[Lori]

Inpatient uses PCS

Outpatient coding refers to a detailed diagnosis report in which the patient is generally treated in one visit, whereas an inpatient coding system is used to report a patient's diagnosis and services based on his duration of stay.

 

[LindseyS_72587]

Inpatient uses PCS

Outpatient coding refers to a detailed diagnosis report in which the patient is generally treated in one visit, whereas an inpatient coding system is used to report a patient's diagnosis and services based on his duration of stay.

Hello! Id like to piggy back on this one. I code surgeries, and for example I was coding an op report. This patient was admitted and the next day they had exploratory/diagnostic laparoscopy - evacuation of hemoperitoneum drainage of left ovarian cyst done. then they were discharged. The hospital charged PCS codes. Is that correct?

Another example, pt had a hysterectomy but then admitted for observation. That would be CPT correct?

 

[Darcy]

Hello! Id like to piggy back on this one. I code surgeries, and for example I was coding an op report. This patient was admitted and the next day they had exploratory/diagnostic laparoscopy - evacuation of hemoperitoneum drainage of left ovarian cyst done. then they were discharged. The hospital charged PCS codes. Is that correct?

Another example, pt had a hysterectomy but then admitted for observation. That would be CPT correct?

Yes, if patient was admitted and had a procedure performed in hospital, the correct code set is PCS for the procedures.
Where was the hysterectomy performed? If outpatient/SDS then CPT.

 

[LindseyS_72587]

Yes, if patient was admitted and had a procedure performed in hospital, the correct code set is PCS for the procedures.
Where was the hysterectomy performed? If outpatient/SDS then CPT.

it states outpt surgery but the patient is inpatient at this hospital. hospital side coded for the inpt surgery. patient admitted 02 for surgery and discharged 03

 

[Darcy]

it states outpt surgery but the patient is inpatient at this hospital. hospital side coded for the inpt surgery. patient admitted 02 for surgery and discharged 03

They can't be both. Either status was observation or inpatient. Who are you trying to code for specifically? The provider or the facility?

 

[LindseyS_72587]

See thats whats I understood too, it cant be both. I bill for the provider. the hospital billed the pcs codes

 

[Darcy]

See thats whats I understood too, it cant be both. I bill for the provider. the hospital billed the pcs codes

Then you only need to be concerned with CPT codes for the provider services while in observation and/or inpatient status