Outpatients Coding

Outpatient Coding:

Outpatient coding, it involves assigning codes to medical procedures, diagnoses, and services provided to patients who receive care on an outpatient basis. Outpatient care refers to healthcare services that do not require an overnight stay in a healthcare facility.

The most significant difference between inpatient coding and outpatient coding is the setting in which the services are provided.

We have below commonly identified POS:

11: Office visit

19: Off campus outpatient

22: On campus outpatient

The E/M section is organized into broad categories:

Office visits

• New patient

• Established patient.

Consultations

• Outpatient consultation: - 99242 to 99245

Office Visit

The following codes are used to report evaluation and management services provided in the office or in an outpatient or other ambulatory facility. A patient is considered an outpatient until inpatient admission to a health care facility occurs.

Determine the patient status as New or established: -

New Patient: A new patient is one who has not received any professional services from the physician or other qualified health care professional or another physician or other qualified health care professional of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years.

Established Patient: An established patient is one who has received professional services from the physician or other qualified health care professional or another physician or other qualified health care professional of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years.

New Patient note example: