Place of Service on UB-04
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Questions and Answers

What is the primary difference between inpatient hospital stay and outpatient hospital service?

  • Admission status of the patient (correct)
  • Location of hospital services
  • Length of hospital stay
  • Type of medical treatment provided
  • What type of services are included in inpatient hospital stay?

  • Room and board, nursing services, and other hospital services (correct)
  • Outpatient surgery and laboratory services
  • Emergency department services
  • Rehabilitation services and medical treatments only
  • What is an example of a service that would be coded as an outpatient hospital service?

  • Rehabilitation services during an inpatient hospital stay
  • Laboratory test conducted in a doctor's office
  • Emergency room visit (correct)
  • Surgical procedure during a 3-day hospital stay
  • What code is used for outpatient hospital service?

    <p>Code 22</p> Signup and view all the answers

    What is a characteristic that distinguishes inpatient hospital stay from outpatient hospital service?

    <p>Patient receives care in a hospital setting for at least 24 hours</p> Signup and view all the answers

    What is a necessary condition for a patient to be coded as an inpatient hospital stay?

    <p>The patient is admitted to the hospital for at least an overnight stay</p> Signup and view all the answers

    Which of the following services should be excluded from billing as an inpatient hospital stay?

    <p>Outpatient surgical procedures</p> Signup and view all the answers

    What is a commonality between inpatient hospital stays and outpatient hospital services?

    <p>Both are provided in a hospital setting</p> Signup and view all the answers

    What is the primary reason to use code 22 for billing?

    <p>The patient received care in a hospital outpatient setting</p> Signup and view all the answers

    What is a key distinction between billing guidelines for inpatient hospital stays and outpatient hospital services?

    <p>Inpatient hospital stays include emergency department services that result in admission, while outpatient hospital services include emergency department visits that do not result in admission</p> Signup and view all the answers

    Study Notes

    Place of Service on UB-04

    Inpatient Hospital

    • Code 21: Inpatient hospital stay
    • Patient receives care in a hospital setting for at least 24 hours
    • Includes room and board, nursing services, and other hospital services
    • Examples:
      • Surgical procedures
      • Medical treatments
      • Rehabilitation services

    Outpatient Hospital

    • Code 22: Outpatient hospital service
    • Patient receives care in a hospital setting, but is not admitted as an inpatient
    • Includes emergency department services, outpatient surgery, and other hospital-based services
    • Examples:
      • Emergency room visits
      • Outpatient surgical procedures
      • Laboratory and radiology services

    Place of Service on UB-04

    • Inpatient Hospital (Code 21): patient receives care in a hospital setting for at least 24 hours
      • Includes room and board, nursing services, and other hospital services
      • Examples of services provided:
        • Surgical procedures
        • Medical treatments
        • Rehabilitation services

    Outpatient Hospital

    • Outpatient Hospital (Code 22): patient receives care in a hospital setting, but is not admitted as an inpatient
      • Includes services such as:
        • Emergency department services
        • Outpatient surgical procedures
        • Laboratory and radiology services
        • Examples of services provided:
          • Emergency room visits
          • Outpatient surgical procedures
          • Laboratory and radiology services

    Place of Service on UB-04

    Inpatient Hospital

    • Code 21 represents inpatient hospital stays
    • Inpatient hospital stays involve an overnight stay in the hospital
    • Services included are room, board, and continuous nursing care
    • Billing guidelines: use for hospital inpatient services, including emergency department services
    • Exclude outpatient services, such as emergency department visits that do not result in admission

    Outpatient Hospital

    • Code 22 represents outpatient hospital services
    • Outpatient hospital services involve care received in a hospital outpatient setting
    • Services included are emergency department visits, outpatient surgical procedures, and other hospital-based outpatient services
    • Billing guidelines: use for hospital outpatient services, including emergency department visits that do not result in admission
    • Exclude inpatient services, such as hospital stays

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    Description

    Identify the correct place of service codes for inpatient and outpatient hospital services on the UB-04 form.

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