Inpatient coding vs Outpatient coding

Medical coding is broadly divided into two categories inpatient coding and outpatient coding. Here are some of the differences. Outpatient coding involves coding charts where the hospital stay is limited to 24 hours. The patient is treated and discharged within 24 hours. Outpatient coding is far easier than inpatient coding. In inpatient coding, the patient is admitted and remains in the hospital til he recovers thus making the hospital stay more than one day. Inpatient coding requires coding of services of each day of the hospital stay thus making is more and more difficult if the hospital stay becomes longer and longer. For procedural coding in outpatient CPT codes are used whereas in inpatient coding ICD procedure are used. In outpatient coding dignosis like suspected, ruleout, probable, or consistent are not coded and instead respective symptoms are codes whereas in inpatient coding all such diagnosis are coded as current conditions. In outpatient coding, abnormal findings are coded as given by the physician whereas in inpatient coding abnormal findings are not coded and reported unless the provider indicates their clinical significance. Inpatient operative reports are very exhaustive and may have hundreds of pages. One more difference between inpatient and outpatient coding is the usge of DRG coding in inpatient coding so the skill sets required for inpatient coding also include DRG expertise. Tags: difference between inpatient outpatient coding, inpatient outpatient coding similar different, medical coders, americal academy of professional coders, healthcare industry, ICD 9

What type of communication do you participate in during your workday? Is most communication done via email, via the phone, in person? Unfortunately, a great deal of my communication is done by email. I've learned over time, to keep my responses short and straightforward, in order to avoid confusion or misinterpretation. I also communicate in groups (meetings, training), and occasionally one-on-one, which I find most effective, particularly if I have to have a difficult conversation. What type of language do you use during the day? Do you find it pertinent to know medical terminology to successfully communicate with others in your same field?My communication must be professional at all times. Slang and expletives have no place in a professional workplace, although I have to admit, I occasionally hear inappropriate language at times from staff members all the way up to physicians. It seems to be much more accepted these days to say words that my mother would have gotten out the Ivory soap for!

Not only must you be knowledgable in medical terminology, but you had better be able to pronounce the terminology correctly, and understand how to use it in a sentence. The best way for a coder to lose credibility in the eyes of a physician is to mis-pronounce medical words when you're trying to train them on their coding. I've actually seen physicians roll their eyes while a coding colleague used the words "smoking sensation" rather than "smoking cessation", and "exasperate" rather than "exacerbate". Coders must learn the language and learn how to pronounce it correctly, or run the risk of appearing (frankly) stupid. What is it like working with others in your career field? Is this a field where it is important for everyone to work as a team or do most work independently? We strongly encourage a team approach, starting from coding assistants through our CMO. In order to achieve our financial and compliance goals, promote patient safety and welfare, and support and encourage our employees, we all have to be on the same page. We often disagree, but do so respectfully. Everyone is expected to fulfil their roles independently without lots of supervision, but we work together to reach our common goals. What is the culture within your career field like? Is it different than that of the nurses in the hospital for example? I think that outside influences impact the culture of the hospital I work for much more than the career itself. I work New Hampshire, and live in Maine, but am only an hour from Boston, so we have a great deal of that city's influence in our daily lives. Although this area of New England is not extremely racially or ethnically diverse, people's attitudes are quite liberal. There are employees and patients at our facility from many ethnic backgrounds, faiths, and orientations, and everyone is treated with respect and consideration. To act otherwise would be extremely frowned upon,and would result in termination. The healthcare industry is no place for prejudice or extreme politics, at least in this part of the country. Education is highly regarded, and employees at this facility are encouraged to excel. The work ethic in New England is known as being extremely strong, and most people work 40-60 hours per week. What might be considered acceptable job performance in another part of the country would be considered slacking here! Clothing and hairstyles are relatively conservative, particularly in this hospital setting, where the guidelines are very clear (no pink hair, multiple piercings, bare feet, or rude tattoos...all of which are methods of communicating "here's who I am"). We are expected to be professional at all times. Mostly, our culture is one of excellent patient care, and in order to do that, our facility expects superior performance from all employees, regardless of their job description. __________________ Pam Brooks, PCS, CPC Physician Services Coding Supervisor Wentworth-Douglass Hospital Dover, NH 03820