Wiki ICD10 coding when a pt is admitted to the hospital-but billed by a private physician

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ksarvis

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Hi,
i work in a group practise doctors office. we also have doctors that we bill for, that see pts in the hospital/ER.
Our hospitalist admit pts, do subsequent visits and discharge pts. We were having a discussion on the ICD10 coding though.

if a pt is admitted to the hospital and our doctor is in charge of their care, would the ICD10 coding be based on InPatient? (meaning you CAN code "probable, possible, looks like") or because we are billing for a Hospitalist (but still coding 99221-99239 for inpatient CPTs), is the ICD10 coding considered Outpatient coding? (meaning that you CANNOT code "possible, probable" etc)?
i really need an answer/opinion on this; please help.
thank you
 
Coding for hospitialist care

In the ICD-10 AAPC version, page 1363, section II, discusses the Selection of Principal Diagnosis. This section will help with ICD-10 selection depending on the setting.
 
thank you. is that in AAPCs version of the ICD10 book? we only have the Optum ones... i showed my coworker the coding guidelines in the front of the ICD10 book, page 28 on how to code for inpatient reimbursement.
she stated that the "Facility" (the hospital?) codes their charts as Inpatient, but that "we code our charts as outpatient" ??? meaning that even though the pt is admitted to the hospital and is an "Inpatient status" that we could our charts as if they are outpatient and cannot code "possible, probable," etc?
the pts are admitted to the hospital. we use Inpatient CPT codes and POS for the Hospital. so why would code the ICD10 portion using guidelines for outpatient services?
that is our debate....
 
When you are looking at the coding guidelines, the guidelines indicated as "inpatient guidelines" such as coding possible, probably, suspected as an existing diagnosis, applies to the inpatient facility coder. They do not apply to the physician coder coding for inpatient visits. Physician guidelines (which are much the same as facility outpatient guidelines )apply to the physician services regardless of setting.
 
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