Week 5 ICD HCPCS CPT Chart

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Bryant & Stratton College *

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Mechanical Engineering

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Jan 9, 2024

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Code Set Comparison Table Coding System CPT- Level I HCPCS ICD-10-CM ICD-10-PCS HCPCS Level II Definition & Usage of Each CPT(Current Procedural Terminology) Codes used to report medical procedures and medical services by providers and healthcare facilities. IDC (International Classification of Diseases: Clinical Modification) Used to classify diagnoses and reasoning for all types of visits in all healthcare settings. ICD (International Classification of Diseases: Procedural Coding System) Used to classify procedures that take place in an inpatient health care setting. HCPCS (Healthcare Common Procedure Coding System) Used for billing services such as ambulance rides and prosthetics. Setting of Care Outpatient Setting All Healthcare Settings Inpatient within a hospital setting Non-physician services ex: (ambulances and prosthetics) Year Adopted 1966 Adoption January 16 th 2009 Implemented on October 1 st 2015 Adoption January 16 th 2009 Implemented on October 1 st 2015 2000

Frequency of Updates Annually ( 1 time a year) Annually ( 1 time a year) Annually ( 1 time a year) Quarterly (4 times a year) Agency that Maintains the Code Set AMA (American Medical Association) NCHS (National Center for Health Statistics) CMS (Center for Medicaid and Medicare Services) CMS (Center for Medicaid and Medicare Services) CPT or as it is also known as HCPCS level I is a coding system used to report medical procedures and medical services provided by healthcare providers as well as healthcare facilities. ICD-10-CM is a coding system used to classify all types of visits in all healthcare settings. ICD-10- PCS is a system that is use in a hospital inpatient setting. HCPCS level II is a coding system that is used to generate a bill for resources or services used outside a hospital setting for example an ambulance ride to the hospital. Each structure of the four-coding classification is formatted differently. CPT or HCPCS level I is a five-digit code an example of a CPT code would be 93306 which is an Echocardiography . HCPCS level II is formatted in a similar way but instead of having five numerical digits it is four numbers followed by a letter still making the code four digits and one alphabet letter making the code alphanumeric an example of this coding would be H0001 which is Alcohol and/or drug assessment. Now over to ICD-10-CM this is set up a. Bit differently than HCPCS. ICD-10-CM is made up between three and seven alphanumeric characters an example of this ICD code would be O9A.211 which is the code for Injury, positioning and certain other consequences of external causes complicating pregnancy, first trimester. For the ICD-10-PCS the format would be seven characters which the first character would be a letter pertaining to a specific part of the body. After the initial character, which is a letter, it would be followed by six characters a mixture of both alphabet and numeric depending on the procedure and location, tool used and a qualifier. An example of this would be 9WB0XBZ which is Chiropractic Manipulation of head, non-Manual. Making sure that all of the codes are current and accurate is extremely important. If the codes were not kept up to date there would be a highly likely chance that a claim that was submitted would be delayed in paying the provider, but it could end up with a denial which would have to be then appealed. It makes a process that isn’t so difficult a lot more difficult. Keeping them updated is only of the only ways that as an employee of a provider it ensures that the provider gets paid but yourself as well. It keeps things moving smoothly and balanced.

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