Three Types of Medical Codes That Coders Use

Read this interesting blog post to find out about the three types of codes used in medical coding. Get to know why it’s important to use these codes.

What is medical coding? What does a medical coder do? A coder is a professional who will collect medical reports from a physician and turn that information (the condition of the patient, the diagnosis of the doctor, the prescription and any other procedure that the physician performed on the patient) into a set of codes. These codes form a crucial part of the medical claims.

Here are three types of codes that you will come across in medical coding.

  1. ICD

    The most commonly known code is ICD codes or International Classification of Diseases code. The World Health Organization (WHO) established the ICD codes during the late 1940s. Since its inception, it has been updated several times. The number, which precedes ICD, stands for the revision of the code. These diagnostic codes were created to develop a uniform vocabulary that could be used to describe the causes of illness, injury or death.

    For instance, the code that is used in the United States is ICD-10-CM. This simply means that it is the 10th revision of the ICD code. The CM at the end of the code stands for clinical modification. The clinical modification revisions were put in place by the National Center for Health Statistics (NCHS). This clinical modification increases the number of codes to a great extent. For instance, if ICD-10 has 14,000 codes, ICD-10-Cm codes will have over 68,000 codes.

    Medical coders use ICD codes to represent the diagnosis given by the doctor and to describe the patient’s condition. During the medical billing process, these codes are used to evaluate the medical necessity. Medical coders will have to make sure that the procedure that they are billing is in sync with the diagnosis given.

    Let us now explore the next two types of procedure codes.

  2. CPT

    CPT or Current Procedure Terminology codes are used to keep a track of the majority of medical procedures that happen at the office of a physician. CPT codes are published and maintained by the AMA (American Medical Association). The codes are copyrighted and updated on a yearly basis.

    These codes are sectioned into three categories. The first category which is used frequently is divided into six ranges which correspond to six major medical fields such as Pathology and Laboratory, and Medicine, Surgery, Radiology., Evaluation and Management, Anesthesia. The next category of CPT codes corresponds to test results and performance measurement. These five digit codes are added to the category 1 CPT code. This category of codes reduces the administrative burden on the physicians office by giving them accurate information.

    The third category of CPT codes deals with emerging medical technology. Medical coders usually spend a majority of their time with the first two categories of CPT codes, with the first one being more common.

  3. HCPCS

    The HCPCS codes or Healthcare Common Procedure Coding system refer to codes that are based on CPT codes. It was developed by the CMS and is maintained by the AMA. The HCPCS codes correspond to procedures, services and equipment that are not covered by CPT codes. This will include ambulance rides, prosthetics, medical equipment and certain drugs.

    These codes are also used Medicaid, Medicare, out patient hospital care and chemotherapy drugs amongst others. Since the HCPCS codes are involved in Medicaid and Medicare, it is the most important codes that a medical coder would be using. HCPCS codes are divided into 2 levels. The first level is identical to CPT codes, which the second level is based on specialties like laboratory, medical or rehabilitative services. Medical coders have to ensure that the HCPCS does correspond with a diagnostic code that is justifiable with the medical report.

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Did you like reading this post? Did you find the information useful? Which of the above three codes does your hospital/clinic have to deal with on a regular basis? Let us know by leaving a comment in the box below. We, at Outsource2india love to hear from you!

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