Inpatient Facility Coding & Compliance Alert

Question: I’ve coded anesthesia and outpatient services for years, and now am learning inpatient coding. I’ve noticed that some inpatient charts list an ICD-9 Volume 3 code instead of a CPT® procedure code. Which should I use -- CPT® or ICD-9?
Tennessee Subscriber Answer: Facility guidelines may vary, but CPT® codes generally are not used on inpatient charts. You will need to select the appropriate ICD-9 procedure codes from ICD-9 Volume 3, as those can affect DRG assignment. Example: An outpatient coder might report 45378 (Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen[s] by brushing or washing, with or without colon decompression [separate procedure]) for a colonoscopy. From an inpatient standpoint, you would report 45.23 (Colonoscopy) or 46.85 (Dilation of intestine) instead, depending on the details of the procedure.