Question

The coding system that is used for outpatient procedure claims is:

A. ICD-10-PCS
B. HCPCS/CPT
C. ICD-10-CM
D. ICD-9

Answer 1

The HCPCS/CPT coding system is used for outpatient procedure claims. It is essential for processing claims efficiently, as it provides uniform information about procedures for healthcare management systems and insurance companies.

Step-by-step explanation:

The coding system used for outpatient procedure claims is HCPCS/CPT.

Outpatient procedures require a systematic coding approach for proper documentation, billing, and insurance purposes. The most commonly used system in the United States for these purposes is the Healthcare Common Procedure Coding System, or HCPCS, which includes the Current Procedural Terminology (CPT) codes developed by the American Medical Association. These codes are specifically designed for reporting medical, surgical, and diagnostic procedures and services.

These codes assist in the efficient processing of outpatient claims by providing uniform information about medical services and procedures, which is essential for healthcare management systems, medical laboratories, and insurance companies for the verification and reimbursement of healthcare services. Medical coders assign these codes based on the procedures performed by clinicians, and medical billers use the coded data to process claims. On the other hand, ICD-10-CM is used for diagnosis coding, rather than procedures, and ICD-10-PCS is used for inpatient procedure coding in hospitals.