What is the Difference Between ICD, CPT, and HCPCS Codes in Medical Coding?

Understanding ICD, CPT, and HCPCS Codes

ICD, CPT, and HCPCS are the three primary medical coding systems. Each has a specific function and is essential to healthcare billing and documentation.

The International Classification of Diseases, or ICD Codes, are used to classify illnesses, ailments, and other medical disorders. These codes were created by the World Health Organization (WHO) and are mostly used in medical records and health statistics for diagnosis coding. ICD-10, the most recent edition, has a large number of codes that offer thorough descriptions of illnesses, wounds, and other medical issues.

The American Medical Association (AMA) created CPT codes (Current Procedural Terminology), which are used to record medical services and procedures. These codes enable healthcare practitioners to convey the services they deliver during patient contacts and are crucial for billing and payment purposes. CPT codes provide for accurate identification of the procedures carried out because they are categorized into groups such as evaluation and management, surgery, and radiography.

Healthcare Common Procedure Coding System (HCPCS) codes are used to add product, supply, and non-physician service codes to CPT codes. HCPCS is split into two tiers and is overseen by the Centers for Medicare and Medicaid Services (CMS): While Level II codes cover things like durable medical equipment, ambulance services, and specific pharmaceuticals, Level I codes are the same as CPT codes.

To summarize, ICD codes are used to categorize diagnoses, CPT codes are used to indicate procedures, and HCPCS codes are used to identify a wider variety of products and services. These codes work in concert to enable precise healthcare billing and data analysis.