What coding system is used in the Inpatient Psychiatric Facilities (IPFs) prospective payment methodology?

The correct answer is the coding system based on ICD-10-CM/ICD-10-PCS codes, which is specifically utilized for the Inpatient Psychiatric Facilities (IPFs) prospective payment methodology.

ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) is employed to classify diagnoses, while ICD-10-PCS (Procedure Coding System) is designed for coding inpatient procedures. The use of these codes ensures that the payment system accurately reflects the clinical services provided to patients in psychiatric settings, allowing for appropriate reimbursement based on the complexity of care.

The IPF prospective payment system relies on these codes to group cases into distinct payment categories, which are critical for determining payment rates for psychiatric hospitals. This methodology considers various factors including diagnosis, treatment, and length of stay, reinforcing the need for precise coding to ensure facilities are reimbursed accurately for the care delivered.

In contrast, while HCPCS/CPT codes are widely used in outpatient settings for billing and reimbursement for procedures and services, they do not directly apply to the inpatient psychiatric payment methodology. Revenue codes play a role in indicating service types but are not the primary coding system used for payment determination in IPFs, further highlighting why the ICD-10 coding