Question

In a 400 words essay, differentiate between those medical coding systems; ICD10, CPT, HCPCS?

Answer 1

Ans.

Current Procedural Terminology (CPT) is a medical code set that is used to report medical, surgical, and diagnostic procedures and services to entities such as physicians, health insurance companies and accreditation organizations.

an example of a CPT code--

CPT codes are, for the most part, grouped numerically. The codes for surgery, for example, are 10021 through 69990. In the CPT codebook, these codes are listed in mostly numerical order, except for the codes for Evaluation and Management. ... The code 99214, for a general checkup, is listed in the E&M codes.

ICD-10 codes are alphanumeric codes used by doctors, health insurance companies, and public health agencies across the world to represent diagnoses. Every disease, disorder, injury, infection, and symptom has its own ICD-10 code.

The ICD-10 code system offers accurate and up-to-date procedure codes to improve health care cost and ensure fair reimbursement policies. The current codes specifically help healthcare providers to identify patients in need of immediate disease management and to tailor effective disease management programs.

HCPCS codes are used for billing Medicare & Medicaid patients — The Healthcare Common Prodecure Coding System (HCPCS) is a collection of codes that represent procedures, supplies, products and services which may be provided to Medicare beneficiaries and to individuals enrolled in private health insurance programs.

The correct HCPCS code plays an essential role in patient access to new and existing technologies for the following reasons. It enables clinicians (providers), manufacturers, and payers to identify with specificity, for billing and claims processing purposes, the product that was furnished to a patient.

CPT codes are the codes used for reporting surgeries and minor procedures and getting paid. When a claim is filed with the CPT procedure code along with the appropriate ICD-10 diagnosis code, payment is made to the providing practitioner. Example: CPT codes are essential for getting payment from insurance.

CPT is a code set to describe medical, surgical ,and diagnostic services; HCPCS are codes based on the CPT to provide standardized coding when healthcare is delivered.

CPT codes are the procedure performed by the physician on patient like X-ray, MRI, CT scan etc. which are coded using a 5 digit numerical code generally. ICD codes are the diagnosis codes. Currently the US healthcare is using the ICD 10 codes which are alphanumberic.

The HCPCS code set is based on the AMA's CPT processes. ... HCPCS includes three separate levels of codes: Level I codes consist of the AMA's CPT codes and is numeric. Level II codes are the HCPCS alphanumeric code set and primarily include non-physician products, supplies, and procedures not included in CPT.

The ICD-10 procedural coding system (ICD-10-PCS) is used by facilities (e.g., hospital) to code procedures. CPT codes are, and will continue to be, used by physicians (and other providers) to report professional services.

HCPCS stands for Healthcare Common Procedure Coding System. ... HCPCS billing codes are monitored by CMS, the Centers for Medicare and Medicaid Services. They are based on the CPT Codes (Current Procedural Technology codes) developed by the American Medical Association.

Answer 2

ICD-10

International statistical Classification of Diseases and related health problems.

It is the international strandard for recording the diseases and health conditions. ICD 10 is the codes of the disease,abnormal condition, symtoms, Injury.

It consists of two divisions which is ICD-10-CM and ICD-10-PCS.Where ICD-10-CM consists of 68000 codes used for diagnosis.CM is the clinical modification.ICD-10-PCS consists of 76,000 codes which is used for hospital inpatient procedure.PCS is the Procedure Coding System.

Implemented by CMS.

CPT.

Current Procedural codes.

These codes are used for reporting minor procedures, surgeries,and for payment.

Three categories of CPT codes are present.

CPT- These codes reports the claims and get paid.

CPT II- They are used for performing measurements.

CPT lll- They are used to help health facilities and agencies by keeping the medical faternity upto date.

Implemented by American Medical Association.

HCPCS.

Healthcare Common Procedures Coding System.

These codes report supplies,devices and equipment provided for the patients.They are the level ll CPT codes.

HCPCS consists of two levels.

HCPCS level 1 compromises of CPT.

HCPCS Level 2 comprises of codes which are not included in CPT codes.

Implemented by Center's for Medicaid and Medicare services.