Certified Inpatient Coding (CIC) Practice Exam

Under APCs, what does status indicator C indicate?

1. Ancillary service

2. Inpatient only procedure

3. Significant procedure, discounted

4. Significant procedure, non-discounted

The correct answer is: Inpatient only procedure

Status indicator C under the Ambulatory Payment Classification (APC) system is used to designate procedures that are classified as "Inpatient only." This means that the procedure is not typically provided in an outpatient setting, and it requires hospitalization for its performance. Understanding this status is crucial for accurate coding and billing, as it helps identify which procedures cannot be billed or performed on an outpatient basis. This classification impacts how health care facilities plan and manage their services, ensuring that inpatient and outpatient resources are allocated appropriately. Procedures marked with status indicator C must meet specific clinical criteria that necessitate inpatient care, making it essential for coders to recognize these designations during the coding process. The other options, while related to the classification of services and procedures, do not apply to the definition of status indicator C as it strictly pertains to procedures that are reserved for inpatient care only.