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Understanding Outpatient Coding and Reporting

Mar 04 2014

There are a great number of employment opportunities in the Health Information Management field. And the experience of medical coding is a challenging and rewarding as any! But what is medical coding? What is the difference between Inpatient and Outpatient coding? If the terms sound a little futuristic for you, good! Because in the Health Information Management field, the future is here!

Not many people even know about the medical coding profession. But it is an excellent profession, with outstanding benefits.

Sometimes it is called medical classification or medical coding. In the process, information is taken from a variety of different sources, including health records, descriptions of physician's notes, lab results, radiology results and other sources. The diagnoses codes are used to track various diseases and health conditions.

In the Health Information Management field there are two types of medical coding. One is outpatient coding, which is used by clinics, physician offices, hospital emergency rooms and ambulatory centers. And with outpatient coding, treatment of the person is done on that same day.



With inpatient coding, you're dealing almost exclusively with acute care facilities. Inpatient coding is done when a patient has been admitted to that type of facility for longer than 24 hours.

Can you become a medical coder? Sure. What you will need to learn from a coding perspective is determined by the difference between inpatient and outpatient coding.

Outpatient Coding Credentials:

For outpatient coding credentials, you should have your AHIMA certification as a Certified Coding Specialist – Physician-based (CCS-P).

And here are books you would need to be familiar with:


  • ICD-10, International Classification of Diseases. Latest Version: 2010.



  • CPT - Current Procedural Terminology (CPT®) which are developed by the American Medical Association and first published in 1966. They are a listing of standardized descriptions and five-character, alphanumeric codes that medical coders and billers use to report health care services and procedures to provide payers for reimbursement.



  • HCPCS - Healthcare Common Procedure Coding System (HCPCS) code set.


Inpatient Coding Credentials:

For inpatient coding credentials, you should have your AHIMA certification as a Certified Coding Specialist (CCS).

And for books, you are required to be familiar with:

  • ICD-10, International Classification of Diseases. Latest Version: 2010.



  • The DRG Expert: a comprehensive reference to the DRG classification system. It is organized by major diagnostic category (MDC) and is a reference for those who need to verify DRG information and accurately assign MS-DRGs concurrently or retrospectively.


Finally, it is important to realize that, whether inpatient or outpatient coding, you need to master the official coding guidelines released by the US Dept. of Health and Human Services!

- Official Outpatient Guidelines

- Official Inpatient Guidelines

For more information about our Medical Coding Services and Medical Coder positions, contact Professional Dynamic Network. By email to: info@pdnseek.com or by telephone at: 1-708-747-4361.

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