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
ɤ Diagnostic codes that create a uniform vocabulary for describing
the causes of injury, illness and death.
ɤ Established by the World Health Organization (WHO) in the late
1940s.
ɤ Updated several times in the 60 – plus years since its inception
ɤ The number following “ICD” represents which revision of the
code is in use.

5. Medical
Coding
ɤ Are used to document the majority of the medical procedures
performed in a physician's office.
ɤ The code set is published and maintained by the American
Medical Association (AMA).
ɤ These codes are copyrighted by the AMA and are updated
annually.

6. Medical
Coding
ɤ The Clinical Modification significantly increases the number of
codes for diagnosis.
ɤ The increased scope gives coders much more flexibility and
specificity, which is essential for the profession.
ɤ The ICD-10 code, has 14,000 codes.
ɤ Its clinical modification, ICD-10-CM, contains over 68,000.

7. Medical
Coding
ɤ CPT codes are five-digit numeric codes.
ɤ The first category is divided into six ranges which
correspond to six major medical fields:
 Evaluation and Management
 Anesthesia
 Radiology
 Surgery
 Medicine
 Pathology and Laboratory

8. Medical
Coding
ɤ The second category of CPT codes corresponds to
performance measurement and in some cases, laboratory or
radiology test results.
ɤ The five-digit, alphanumeric codes are typically added to the
end of a Category I CPT code with a hyphen.
ɤ The third category of CPT codes corresponds to emerging
medical technology.

9. Medical
Coding
ɤ CPT codes also have addendums that increase the
specificity and accuracy of the code used.
ɤ CPT Modifiers are two-digit numeric or alphanumeric codes
that are added to the end of the category I CPT code.
ɤ They provide important additional information to the
procedure code.
ɤ E.g. a CPT modifier that describes which side of the body a
procedure is performed on, and there’s also a code for a
discontinued procedure.

10. Medical
Coding
ɤ This includes durable medical equipment, prosthetics,
ambulance rides, and certain drugs and modifiers.
ɤ HCPCS is also the official code set for outpatient hospital
care, chemotherapy drugs, Medicaid, and Medicare, among
other services.
ɤ Since HCPCS codes are involved in Medicaid and Medicare,
its one of the most important code a medical coder can use.

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

12. Medical
Coding
ɤ Read all four sections of the current ICD-10-CM Official
Guidelines for Coding and Reporting.
 Section I. Conventions, general coding guidelines and
chapter specific guidelines.
 Section II. Selection of Principal Diagnosis.
 Section III. Reporting Additional Diagnosis.
 Section IV. Diagnostic Coding and Reporting
Guidelines for Outpatient Services.

13. Medical
Coding
ɤ Describes structure and conventions of the classification and
general guidelines that apply to the entire classification, and
chapter-specific guidelines that correspond to the chapters as
they are arranged in the classification.
1
•Conventions for the ICD-10-CM
2
•General Coding Guidelines
3
•Chapter-Specific Coding Guidelines

14. Medical
Coding
ɤ Section II includes guidelines for the selection of principal
diagnosis for non-outpatient settings.
ɤ Section III includes guidelines for reporting additional
diagnosis in non-outpatient settings.
ɤ Section IV is for outpatient coding and reporting