10 Questions
What is the primary difference between inpatient hospital stay and outpatient hospital service?
Admission status of the patient
What type of services are included in inpatient hospital stay?
Room and board, nursing services, and other hospital services
What is an example of a service that would be coded as an outpatient hospital service?
Emergency room visit
What code is used for outpatient hospital service?
Code 22
What is a characteristic that distinguishes inpatient hospital stay from outpatient hospital service?
Patient receives care in a hospital setting for at least 24 hours
What is a necessary condition for a patient to be coded as an inpatient hospital stay?
The patient is admitted to the hospital for at least an overnight stay
Which of the following services should be excluded from billing as an inpatient hospital stay?
Outpatient surgical procedures
What is a commonality between inpatient hospital stays and outpatient hospital services?
Both are provided in a hospital setting
What is the primary reason to use code 22 for billing?
The patient received care in a hospital outpatient setting
What is a key distinction between billing guidelines for inpatient hospital stays and outpatient hospital services?
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
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
- Includes services such as:
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
Identify the correct place of service codes for inpatient and outpatient hospital services on the UB-04 form.
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