The main difference between inpatient and outpatient services is that inpatient care is performed by an inpatient facility that is prepared for patients to be able to stay overnight if need be. This inpatient care can be provided by a hospital, skilled nursing facility, or a long term care facility. A skilled nursing facility (SNF) is designed to provide rehabilitation services and/or skilled nursing to injured patients after they no longer need to be in a hospital setting. The skilled nursed help the patient and assist with their recovery. A skilled nursing facility is operated by licensed nurses, with the assistance of a medical physician. A few examples of care given at a skilled nursing facility would include dressing changes, intravenous injections, and tube feeding.
A nursing home is an example of a long-term care facility, which provides custodial care for patients who suffer from chronic disabilities or prolonged illnesses. Outpatient care, is also referred to as ambulatory care, is somewhat different from inpatient care in a hospital or skilled nursing facility setting. Outpatient care involves care that does not require and overnight stay. This kind of care is found in a family physician office, ER visit, physical, speech or occupational therapy, and home health care.
Due to the different settings and types of treatment received at inpatient or outpatient facilities, there are different codes for all the different procedures. An inpatient care example would be an overnight stay and care that is a round-the-clock due to a surgical procedure received. If it was outpatient care the service or treatment would have been in the doctor’s office or facility. Outpatient care codes differ than inpatient due to their different settings and what services can be performed.
Coding for inpatient and outpatient are different, diagnostic coding for inpatient care follow the rules of the Uniform Hospital Discharge Data Set (UHDDS). Inpatient coding differ from physician and outpatient coding, because the main diagnosis is generally determined after study in a hospital setting and coding an unconfirmed condition as the admitting diagnosis is permitted. Inpatient codes can be more complex than outpatient, in general there are more codes used in inpatient care than outpatient.