Outpatient coding guidelines

Outpatient coding guidelines differ from inpatient coding guidelines and has been listed below.

1. The primary diagnosis should be the condition which is the principle cause of patient visit established after study.
2. Differential diagnosis stated by the physician in the final impression should not coded instead symptoms must be coded. For example physician may state UTI/diverticulitis in the final impression, which should not be coded instead symptoms like abdominal pain should be coded as final diagnosis.
3. Laboratory and radiology findings interpreted by the physician can be coded as diagnosis in outpatient coding.
4. Acute state of a disease should be coded before chronic state if both exists. For example if the final diagnosis is acute and chronic bronchitis, acute bronchitis should be coded first and than chronic bronchitis.
5. Conditions stated by the physician by words "likely", "possible", "Rule out" are not coded in outpatient coding and instead symptoms need to be coded.