Home ICD 10 CM, ICD 10 PCS, HCPCS, CPT

ICD 10 CM, ICD 10 PCS, HCPCS, CPT

ICD-10 CM—

International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) provided by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), for medical coding and reporting in the United States. The ICD-10-CM is a morbidity classification for classifying diagnoses and reason for visits in all American health care settings. The ICD-10-CM is based on the ICD-10, the statistical classification of disease published by the World Health Organization (WHO) which replaces ICD-9.

ICD 10 PCS—

The ICD-10 Procedure Coding System (ICD-10-PCS) is an international system of medical classification used for procedural coding. The Centers for Medicare and Medicaid Services, the agency responsible for maintaining the inpatient procedure code set in the U.S., contracted with 3M Health Information Systems in 1995 to design and then develop a procedure classification system to replace Volume 3 of ICD-9-CM. ICD-9-CM contains a procedure classification; ICD-10-CM does not. ICD-10-PCS is the result. ICD-10-PCS was initially released in 1998. It has been updated annually since that time.

HCPCS-

HCPCS Level II codes are alphanumeric medical procedure codes, primarily for non-physician services such as ambulance services and prosthetic devices,. They represent items, supplies and non-physician services not covered by CPT-4 codes (Level I). Level II codes are composed of a single letter in the range A to V, followed by 4 digits. Level II codes are maintained by the US Centers for Medicare and Medicaid Services (CMS). There is some overlap between HCPCS codes and National Drug Code (NDC) codes, with a subset of NDC codes also in HCPCS, and vice versa. The CMS maintains a crosswalk from NDC to HCPCS in the form of an Excel file. The crosswalk is updated quarterly.

Types of Level II codes

The letters at the beginning of HCPCS Level II codes have the following meanings:

  • A-codes (example:A0021): Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental
  • B-codes (example:B4034): Enteral and Parenteral Therapy
  • C-codes (example:C1300): Temporary Hospital Outpatient Prospective Payment System
  • D-codes: Dental Procedures
  • E-codes (example:E0100): Durable Medical Equipment
  • G-codes (example:G0008): Temporary Procedures & Professional Services
  • H-codes (example:H0001): Rehabilitative Services
  • J-codes (example:J0120): Drugs Administered Other Than Oral Method, Chemotherapy Drugs
  • K-codes (example:K0001): Temporary Codes for Durable Medical Equipment Regional Carriers
  • L-codes (example:L0112): Orthotic/Prosthetic Procedures
  • M-codes (example:M0064): Medical Services
  • P-codes (example:P2028): Pathology and Laboratory
  • Q-codes (example:Q0035): Temporary Codes
  • R-codes (example:R0070): Diagnostic Radiology Services
  • S-codes (example:S0012): Private Payer Codes
  • T-codes (example:T1000): State Medicaid Agency Codes
  • V-codes (example:V2020): Vision/Hearing Services

CPT—

The Current Procedural Terminology (CPT) code set is a medical code set maintained by the American Medical Association through the CPT Editorial Panel.[1] The CPT code set (copyright protected by the AMA) describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among physicians, coders, patients, accreditation organizations, and payers for administrative, financial, and analytical purposes.

New editions are released each October. The current version is the CPT 2015. It is available in both a standard edition and a professional edition.

CPT coding is similar to ICD-9 and ICD-10 coding, except that it identifies the services rendered, rather than the diagnosis on the claim (ICD-10-CM was created for diagnostic coding- it took the place of Volume 3 of the ICD-9). The ICD code sets also contain procedure codes (ICD-10-PCS codes), but these are only used in the inpatient setting.

CPT is currently identified by the Centers for Medicare and Medicaid Services (CMS) as Level 1 of the Healthcare Common Procedure Coding System.

The Current Procedural Terminology (CPT) was developed by the American Medical Association (AMA).

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