Outpatient Care and Facets

All health care services can be broadly divided as two major categories- Outpatient Care and Inpatient Care.

The care a patient receives without being admitted to a hospital, such as at a doctor's office, clinic or same-day surgery center is known as Outpatient Care. Home health services and hospice care are also included in this category. Some plans may limit coverage to no more than 45 days.

Who is an outpatient?

Ø  An outpatient  is a patient who is not hospitalized overnight but who visits a hospital, clinic, or associated facility for diagnosis or treatment. An outpatient is a patient who is hospitalized for less than 24 hours.

Ø  A patient is an outpatient if he is  getting emergency department services, observation services, outpatient surgery, lab tests, or X-rays, or any other hospital services, and the doctor hasn't written an order to admit him to a hospital as an inpatient. In these cases, he is  an outpatient even if he spends the night in the hospital.

Ø  A patient is any recipient of health care services. The patient is most often ill or injured and in need of treatment by a advanced practice registered nurse, physiotherapist, physician, physician assistant, psychologist, podiatrist, veterinarian, or other health care provider.

Facets uses different codes for places of treatments(POT). POT for  Outpatient Care depends on  from what type of provider the patient is receiving medical services/treatments. As applications of Facets can be configured as per health care payers' requirements, codes for POT/POS may be different. I am giving below some typical POT/POS  codes for Outpatient Care.

POT/POS  Codes	Meaning
01	Pharmacy
11	Office
12	Patient’s Home
17	Retail Health Clinic
20	Urgent Care Facility
22	Outpatient Hospital
23	Emergency Room–Hospital
31	Skilled Nursing Facility
52	Psychiatric Facility Partial Hospitalization
65	End Stage Renal Disease Treatment Facility
72	Rural Health Clinic
81	Independent Laboratory