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.
- CHAPTER I – Certain infectious and parasitic diseases (A00-B99)
- CHAPTER II – Neoplasms (C00-D49)
- CHAPTER III – Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)
- CHAPTER IV – Endocrine, nutritional and metabolic diseases (E00-E90)
- CHAPTER V – Mental and behavioral disorders (F01-F99)
- CHAPTER VI – Diseases of the nervous system (G00-G99)
- CHAPTER VII – Diseases of the eye and adnexa (H00-H59)
- CHAPTER VIII – Diseases of the ear and mastoid process (H60-H95)
- CHAPTER IX – Diseases of the circulatory system (I00-I99)
- CHAPTER X – Diseases of the respiratory system (J00-J99)
- CHAPTER XI – Diseases of the digestive system (K00-K93)
- CHAPTER XII – Diseases of the skin and subcutaneous tissue (L00-L99)
- CHAPTER XIII – Diseases of the musculoskeletal system and connective tissue (M00-M99)
- CHAPTER XIV – Diseases of the genitourinary system (N00-N99)
- CHAPTER XV – Pregnancy, childbirth and the puerperium (O00-O99)
- CHAPTER XVI – Certain conditions originating in the perinatal period (P00-P96)
- CHAPTER XVII – Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- CHAPTER XVIII – Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)
- CHAPTER XIX – Injury, poisoning and certain other consequences of external causes (S00-T98)
- CHAPTER XX – External causes of morbidity (V01-Y99)
- CHAPTER XXI – Factors influencing health status and contact with health services (Z00-Z99)
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 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
The Current Procedural Terminology (CPT) code set is a medical code set maintained by the American Medical Association through the CPT Editorial Panel. 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).
- 1Types of code
- 1Category I
- 2Category II
- 3Category III