A guide to medical procedure codes

Medical procedure codes help to create an efficient health diagnosis, treatment, patient billing, medical claim and reimbursement system. These medical codes are not only useful to healthcare providers and insurance companies, but also to patients who can receive relevant information about their diagnosis, treatment, medical costs and insurance claim reimbursement with the help of these codes. This article guides you to medical procedure codes.

What are medical codes?

Medical codes refer to a standard system of coding used to denote medical diagnoses and treatments, and determine cost and reimbursement for various medical procedures. These medical procedure codes are also used to relate different diseases or drugs to one another. Medical codes make billing services more efficient and simplify the medical claim procedure of insurance providers. Patients can also make use of these codes to know the details of their medical diagnosis, get a better insight about the services their health consultant or practitioner has provided, and also to cross-verify their medical bill from the insurer or the healthcare provider.

CPT code system

Current Procedural Terminology (CPT) Coding System was devised by the American Medical Association to denote various health services that a healthcare provider may offer to patients. CPT codes make it easier to enlist all such services, and submit the list to Medicare or private health insurance companies for reimbursement purposes.

HCPCS code system

Healthcare Common Procedure Code System (HCPCS) is used exclusively for Medicare claims. Level 1 HCPCS codes are the same as CPT codes. Level 2 HCPCS codes are different from the CPT coding system. They are used to describe medical supplies, medical equipment and special services such as ambulance service in hospitals. Level 2 codes typically denote services that are provided outside a physician’s office.

ICD code system

International Classification of Diseases (ICD) is maintained globally by the World Health Organization (WHO). In the United States, this coding system is maintained by the Centre for Disease Control (CDC). ICD codes have a number attached to them because these codes keep changing over a period of time. The number denotes which set of codes is in use at any given point of time. Many healthcare service providers in the U.S. have migrated to ICD-10 codes, and by 2015, ICD-11 codes will be implemented.