Who typically works with ICD-10-CM and ICD-10-PCS in medical coding?

In the realm of medical coding, ICD-10-CM and ICD-10-PCS are crucial classification systems used to code diagnoses and procedures. ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) is primarily used for coding diagnoses in outpatient and some inpatient settings, while ICD-10-PCS (International Classification of Diseases, 10th Revision, Procedure Coding System) is exclusively applied to inpatient hospital procedures.

Inpatient coders focus on coding for patients who are admitted to hospitals. They utilize both ICD-10-CM for diagnoses and ICD-10-PCS for procedures performed during the hospital stay. This makes inpatient coders essential in ensuring accurate documentation and billing for services rendered within the hospital setting, as they are trained to interpret complex medical records and accurately assign codes based on the services provided during a patient’s inpatient stay.

Other roles, such as outpatient coders, nursing staff, and administrative staff, may be involved in aspects of coding and healthcare documentation but do not focus on both ICD-10-CM and ICD-10-PCS in a manner comparable to inpatient coders. Outpatient coders primarily use ICD-10-CM but do not typically engage with ICD-10-PCS, while