Hospital Outpatient & Facility Coding

Hospital outpatient facility coders code the hospital's claim (UB-04, TOB 013x) for ED visits, outpatient surgery, observation, clinics, imaging and infusion. • Diagnoses: ICD-10-CM using outpatient rules (no uncertain diagnoses). • Procedures: CPT/HCPCS (not ICD-10-PCS) with revenue codes. • Payment: OPPS/APCs, with packaging and status indicators. • Edits: the Outpatient Code Editor (OCE) and NCCI for hospitals.