Types of medical coding

Coding types

2. Medical
Coding
C
O
N
T
E
N
T
S

3. Medical Coding
International Classification of
Diseases
IDC
Current Procedural Terminology
CPT
Healthcare Common Procedure Coding
System
HCPCS

4. Medical
Coding
ɤDiagnosticcodesthatcreateauniformvocabularyfordescribing
thecausesofinjury,illnessanddeath.
ɤEstablishedbytheWorldHealthOrganization(WHO)inthelate
1940s.
ɤUpdatedseveraltimesinthe60–plusyearssinceitsinception
ɤThenumberfollowing“ICD”representswhichrevisionofthe
codeisinuse.

5. Medical
Coding
ɤAreusedtodocumentthemajorityofthemedicalprocedures
performedinaphysician'soffice.
ɤThecodesetispublishedandmaintainedbytheAmerican
MedicalAssociation(AMA).
ɤThesecodesarecopyrightedbytheAMAandareupdated
annually.

6. Medical
Coding
ɤTheClinicalModificationsignificantlyincreasesthenumberof
codesfordiagnosis.
ɤTheincreasedscopegivescodersmuchmoreflexibilityand
specificity,whichisessentialfortheprofession.
ɤTheICD-10code,has14,000codes.
ɤItsclinicalmodification,ICD-10-CM,containsover68,000.

7. Medical
Coding
ɤCPTcodesarefive-digitnumericcodes.
ɤThefirstcategoryisdividedintosixrangeswhich
correspondtosixmajormedicalfields:
EvaluationandManagement
Anesthesia
Radiology
Surgery
Medicine
PathologyandLaboratory

8. Medical
Coding
ɤThesecondcategoryofCPTcodescorrespondsto
performancemeasurementandinsomecases,laboratoryor
radiologytestresults.
ɤThefive-digit,alphanumericcodesaretypicallyaddedtothe
endofaCategoryICPTcodewithahyphen.
ɤThethirdcategoryofCPTcodescorrespondstoemerging
medicaltechnology.

9. Medical
Coding
ɤCPTcodesalsohaveaddendumsthatincreasethe
specificityandaccuracyofthecodeused.
ɤCPTModifiersaretwo-digitnumericoralphanumericcodes
thatareaddedtotheendofthecategoryICPTcode.
ɤTheyprovideimportantadditionalinformationtothe
procedurecode.
ɤE.g.aCPTmodifierthatdescribeswhichsideofthebodya
procedureisperformedon,andthere’salsoacodefora
discontinuedprocedure.

10. Medical
Coding
ɤThisincludesdurablemedicalequipment,prosthetics,
ambulancerides,andcertaindrugsandmodifiers.
ɤHCPCSisalsotheofficialcodesetforoutpatienthospital
care,chemotherapydrugs,Medicaid,andMedicare,among
otherservices.
ɤSinceHCPCScodesareinvolvedinMedicaidandMedicare,
itsoneofthemostimportantcodeamedicalcodercanuse.

11. Medical
Coding
ICD-10-CM
guidelines
The Centers for
Medicare &
Medicaid
Services
(CMM) website
Medical
dictionary
Novitas
Solutions
website

12. Medical
Coding
ɤReadallfoursectionsofthecurrentICD-10-CMOfficial
GuidelinesforCodingandReporting.
SectionI.Conventions,generalcodingguidelinesand
chapterspecificguidelines.
SectionII.SelectionofPrincipalDiagnosis.
SectionIII.ReportingAdditionalDiagnosis.
SectionIV.DiagnosticCodingandReporting
GuidelinesforOutpatientServices.

13. Medical
Coding
ɤDescribesstructureandconventionsoftheclassificationand
generalguidelinesthatapplytotheentireclassification,and
chapter-specificguidelinesthatcorrespondtothechaptersas
theyarearrangedintheclassification.
1
•Conventions for the ICD-10-CM
2
•General Coding Guidelines
3
•Chapter-Specific Coding Guidelines

14. Medical
Coding
ɤSectionIIincludesguidelinesfortheselectionofprincipal
diagnosisfornon-outpatientsettings.
ɤSectionIIIincludesguidelinesforreportingadditional
diagnosisinnon-outpatientsettings.
ɤSectionIVisforoutpatientcodingandreporting