Question

multiple choice question

which of the following are used when coding in the outpatient (physician practice) setting?

rule out diagnoses
suspicions
probabilities
reported symptoms

Explanation:

Identify outpatient coding rules

According to the official ICD-10-CM Outpatient Coding Guidelines, do not code diagnoses documented as "probable," "suspected," "questionable," "rule out," "compatible with," or "consistent with," or other similar terms indicating uncertainty. Rather, code the condition(s) to the highest degree of certainty for that encounter/visit, such as Acute Symptoms, signs, abnormal test results, or other reasons for the visit.

Evaluate the given options

• Rule out diagnoses: Incorrect. These represent uncertain diagnoses and are not coded in outpatient settings.
• Suspicions: Incorrect. Suspected conditions are not coded in outpatient settings.
• Probabilities: Incorrect. Probable conditions are not coded in outpatient settings.
• Reported symptoms: Correct. When a definitive diagnosis is not established, the coder must report the signs and symptoms that prompted the encounter. This aligns with Inconclusive Diagnoses Coding rules for outpatient services.

Answer:

• Rule out diagnoses
• Suspicions
• Probabilities
• Reported symptoms (Correct answer)