Medical coding is the process of transforming transcribed data into set of numerical codes using a system of numbers to represent various medical problems, (diagnoses), and treatments (procedures
http://cpc.certifiedcodertraining.com/index.php/what-is-medical-coding | Curious about the field of Medical Coding? Certified Coder presents a brief overview of Medical Coding and why it is important.
Comprehensive Medical Coding and Billing Training for the AAPC CPC Exam. Online Training with videos and Skype sessions. HIPAA Training included along with Medical Billing. Trainer is Dr Guptha, world record holder.
Medical coding is the process of transforming transcribed data into set of numerical codes using a system of numbers to represent various medical problems, (diagnoses), and treatments (procedures
http://cpc.certifiedcodertraining.com/index.php/what-is-medical-coding | Curious about the field of Medical Coding? Certified Coder presents a brief overview of Medical Coding and why it is important.
Comprehensive Medical Coding and Billing Training for the AAPC CPC Exam. Online Training with videos and Skype sessions. HIPAA Training included along with Medical Billing. Trainer is Dr Guptha, world record holder.
Medical billing and coding summary are useful while handling medico legal services. This ppt explains about what is medical billing and coding, how they are done.
Electronic Health Record System and Its Key Benefits to Healthcare IndustryCalance
This case study discusses how Electronic Health Record can turn out to be a solution to the problems associated with paper based clinical records. It’s a future-proof solution decreasing chances of error and loss while increasing patient-provider communication. Find out the key challenges faced by US health industry, key benefits of EHRs, and how Calance can help developing an HER solution. For more info about Calance, visit http://www.calanceus.com
Dan Wellisch gave this presentation to the Chicago Technology For Vaue Based Healthcare Meetup at https://www.meetup.com/Chicago-Technology-For-Value-Based-Healthcare-Meetup/
standardized codes to medical terms, procedures, and products. Medical coding is used to ensure consistency and accuracy in the collection, analysis, and reporting of clinical data. The following are some of the ways in which medical coding is used in clinical research:
Adverse event coding: Adverse events (AEs) are coded using standardized coding dictionaries such as MedDRA (Medical Dictionary for Regulatory Activities) or WHO Drug Dictionary. This allows for consistent reporting and analysis of AEs across different studies and databases.
Medical history coding: Medical history information is coded using the International Classification of Diseases (ICD) system, which allows for standardized and consistent coding of diseases and medical conditions.
Procedure coding: Procedures performed during clinical trials, such as surgeries or imaging studies, are coded using standardized coding systems such as the Current Procedural Terminology (CPT) or the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM).
Product coding: Medical products used in clinical trials, such as drugs and devices, are coded using standardized coding systems such as the Anatomical Therapeutic Chemical (ATC) classification system or the National Drug Code (NDC) system. This allows for consistent reporting and analysis of product-related data across different studies and databases.
Quality control: Medical coding is also used as a quality control measure to ensure the accuracy and completeness of clinical data. Double coding and consistency checks are used to minimize errors and ensure data quality.
Comprehensive Medical Coding and Billing Training for the AAPC CPC Exam. Online Training with videos and Skype sessions. HIPAA Training included along with Medical Billing. Trainer is Dr Guptha, world record holder.
ICD-10 Presentation Takes Coding to New HeightsPYA, P.C.
PYA Staff Consultant Kim-Marie Walker updated physicians at Robins Air Force Base on the latest in ICD-10 as part of “Soaring Together: A Collaboration in Continuing Medical Education."
ICD-10-CM is the United States’ clinical modification of the World Health Organization’s (WHO) International Classification of Diseases (ICD) Tenth Revision. It is used to classify diseases and causes of illness recorded on health records, claims, and other vital information.
The U.S. Department of Health and Human Services (HHS) will require covered entities (i.e., health plans, health care providers, and health care clearinghouses) that conduct electronic HIPAA standard transactions to move from ICD-9 to the next generation ICD-10 code sets by October 1, 2015.
Short overview over possibilities and challenges of using artificial intelligence in health care. Presentation from the MultiHelix ThinkTank, May 14 2020.
Medical coding textbook for beginners that is easy to read and understand. Covers diagnosis coding with ICD-9-CM and ICD-10-CM and procedure coding with CPT-4, HCPCS, and ICD-10-PCS. This presentation showcases all of this textbook's features.
Medical billing and coding summary are useful while handling medico legal services. This ppt explains about what is medical billing and coding, how they are done.
Electronic Health Record System and Its Key Benefits to Healthcare IndustryCalance
This case study discusses how Electronic Health Record can turn out to be a solution to the problems associated with paper based clinical records. It’s a future-proof solution decreasing chances of error and loss while increasing patient-provider communication. Find out the key challenges faced by US health industry, key benefits of EHRs, and how Calance can help developing an HER solution. For more info about Calance, visit http://www.calanceus.com
Dan Wellisch gave this presentation to the Chicago Technology For Vaue Based Healthcare Meetup at https://www.meetup.com/Chicago-Technology-For-Value-Based-Healthcare-Meetup/
standardized codes to medical terms, procedures, and products. Medical coding is used to ensure consistency and accuracy in the collection, analysis, and reporting of clinical data. The following are some of the ways in which medical coding is used in clinical research:
Adverse event coding: Adverse events (AEs) are coded using standardized coding dictionaries such as MedDRA (Medical Dictionary for Regulatory Activities) or WHO Drug Dictionary. This allows for consistent reporting and analysis of AEs across different studies and databases.
Medical history coding: Medical history information is coded using the International Classification of Diseases (ICD) system, which allows for standardized and consistent coding of diseases and medical conditions.
Procedure coding: Procedures performed during clinical trials, such as surgeries or imaging studies, are coded using standardized coding systems such as the Current Procedural Terminology (CPT) or the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM).
Product coding: Medical products used in clinical trials, such as drugs and devices, are coded using standardized coding systems such as the Anatomical Therapeutic Chemical (ATC) classification system or the National Drug Code (NDC) system. This allows for consistent reporting and analysis of product-related data across different studies and databases.
Quality control: Medical coding is also used as a quality control measure to ensure the accuracy and completeness of clinical data. Double coding and consistency checks are used to minimize errors and ensure data quality.
Comprehensive Medical Coding and Billing Training for the AAPC CPC Exam. Online Training with videos and Skype sessions. HIPAA Training included along with Medical Billing. Trainer is Dr Guptha, world record holder.
ICD-10 Presentation Takes Coding to New HeightsPYA, P.C.
PYA Staff Consultant Kim-Marie Walker updated physicians at Robins Air Force Base on the latest in ICD-10 as part of “Soaring Together: A Collaboration in Continuing Medical Education."
ICD-10-CM is the United States’ clinical modification of the World Health Organization’s (WHO) International Classification of Diseases (ICD) Tenth Revision. It is used to classify diseases and causes of illness recorded on health records, claims, and other vital information.
The U.S. Department of Health and Human Services (HHS) will require covered entities (i.e., health plans, health care providers, and health care clearinghouses) that conduct electronic HIPAA standard transactions to move from ICD-9 to the next generation ICD-10 code sets by October 1, 2015.
Short overview over possibilities and challenges of using artificial intelligence in health care. Presentation from the MultiHelix ThinkTank, May 14 2020.
Medical coding textbook for beginners that is easy to read and understand. Covers diagnosis coding with ICD-9-CM and ICD-10-CM and procedure coding with CPT-4, HCPCS, and ICD-10-PCS. This presentation showcases all of this textbook's features.
The transition to ICD-10 will affect several areas within your hospital, which means changes for most of your staff.
Areas include:
IT Systems Changes
Staff Education and Training
Business Process and Documentation Changes
Changes in Super-Bills Charges
Increased Documentation Costs
Cash Flow Disruptions
Reporting Changes
The ICD-10 Impacts presentation describes these changes and what they mean for your organization.
Use this presentation to educate and prepare your staff for the impacts of the new coding system so they are ready for the transition and the changes they will experience when the October 1, 2014 deadline hits.
Download the presentation here: http://bit.ly/13JjgG9
Institute of medical coding-Top 5 in Trivandrum|SignatureGayathriAbhilash4
Best medical coding institutes in Trivandrum Kerala-Signature-
Medical coding is an important field in healthcare administration that involves assigning specific codes to medical diagnoses, procedures, and services for reimbursement, research, quality improvement, and compliance purposes.
In addition to coding-specific training, you will receive instruction on medical terminology, anatomy and physiology, and other essential skills for medical coding. You will have the opportunity to learn from experienced instructors, network with peers, and gain valuable skills that can help you succeed in this rewarding and in-demand field. Admissions for medical coding institutes are currently open, offering a comprehensive curriculum that covers the latest coding guidelines and technologies, such as ICD-10-CM, CPT, and HCPCS coding.
During your training, you will learn how to use specialized software and coding manuals to accurately assign codes to medical records, as well as understand the importance of ethical and legal considerations in medical coding. You will also receive hands-on training in medical terminology, anatomy and physiology, and other essential skills for medical coding. Qualified and experienced trainers are available..100 percent exam results.. AAPC certified.. If you are interested in pursuing a career in medical coding, now is a great time to consider applying to a reputable medical coding institute. By joining a medical coding institute, you will have the opportunity to learn from experienced instructors, network with peers, and gain valuable skills that can help you succeed in this rewarding and in-demand field. Upon completion of your medical coding program, you will be well-prepared to take national certification exams, such as the Certified Professional Coder (CPC) or Certified Coding Specialist (CCS), which can help you advance your career in medical coding... Admissions open.. limited seats available.. Apply Now..
Improving Medical Coding Effeciency With AI.pdfClinosolIndia
Medical coding is a critical component of healthcare administration, translating complex medical information into standardized codes for billing, reimbursement, and record-keeping. The integration of Artificial Intelligence (AI) into medical coding processes has emerged as a transformative force, promising to enhance efficiency and accuracy. This article explores the key ways in which AI is improving medical coding workflows, ultimately streamlining healthcare operations.
David Farber (http://bit.ly/2DFnvJ1), Head of the FDA and Reimbursement Practice at King & Spalding in Washington DC, leads a workshop for medtech and digital health companies seeking US reimbursement. He brings 30+ years of experience in US Healthcare reimbursement, lobbying and FDA regulatory issues. In addition to ongoing reimbursement challenges, 2020 will see a fundamental transformation in US medical reimbursement (http://bit.ly/2YWlYbt), particularly in digital health. That includes 394 Current Procedural Terminology (CPT) code changes, 248 new codes, 71 deletions and 75 revisions
optum360.comOptum360 powers HIM and CDI modernizationE.docxvannagoforth
optum360.com
Optum360 powers HIM and CDI modernization
Experience matters
Since 1999, Optum has expanded its
LifeCode NLP technology based on
success driven by the performance of
its clients. The depth of experience
spans across health care settings,
medical specialties and varying
encounters covering both physician-
and hospital-based services.
The only patented NLP
technology on the market today
Decision-makers are facing the need to transition to value-based care with pressure to move toward
metrics around quality, safety and outcomes, in addition to optimizing reimbursement. Reliable and
accurate capture of information in these areas is growing the expectations of traditional HIM operations
to work in concert with colleagues in CDI, case management and compliance. NLP technology that can
accurately capture information at the concept level to refl ect the complete health story of a patient is key to
meeting these expectations today in CAC, and tomorrow across settings.
LifeCode NLP technology is uniquely suited to meet this market need through its patented capabilities
that allow recognition of precise clinical details along with content, syntax and multiple semantic
attributes. It does this through an integration of linguistic analysis with a knowledge base of more
than 10 million medical facts.
Better together: A comprehensive solution
The Optum Enterprise Computer-Assisted Coding (CAC) and Optum CDI 3D platform bring together the
power of LifeCode NLP with the tools needed to streamline operations and the partnership to ensure your
ongoing success. Powerful technology combined with a team of experts armed with comprehensive analytics
ensures your organization is positioned for success in today’s ever-changing health care environment.
Optum Enterprise CAC leverages LifeCode NLP to identify code-able facts.
With Optum Enterprise CAC, coders leverage the encoder, logic, workfl ow and NLP code assignment
functionalities to ensure more complete and accurate coding, while providing the traceability and
operational tools to ensure cases are coded in a timely manner.
Optum CDI 3D leverages LifeCode NLP to identify gaps in documentation.
Optum CDI 3D takes documentation improvement opportunities to the next level, with intuitive, intelligent
and clinically based case-fi nding technology that allows CDI specialists to concentrate effort on the right
cases at the right time. In addition, the Optum CDI Program offers the education, preparation and support
to drive the successful growth in your program.
By the numbers:
• Approximately 500 Enterprise CAC clients
sites now using Enterprise CAC, with 100
more scheduled for implementation
• Nearly 200 sites now using CDI 3D, with
100 more scheduled for implementation
• Successful integration with 30+ hospital
EHR and revenue cycle systems
• 1 billion unique clinical documents
processed by LifeCode annually
• Proprietary NLP approach supported by
fi ve pat ...
Exciting news! Instapay Healthcare Services is now offering highly affordable ICD-10 Coding Services in the US. We understand the importance of accurate coding in healthcare, and our team of experts is here to ensure that your coding needs are met efficiently and effectively. With our cost-effective solutions, you can streamline your coding processes without breaking the bank. Trust Instapay Healthcare Services for reliable and affordable ICD-10 Coding Services. Contact us today to learn more!
ICD-10 PCS: Harnessing the Power of Procedure CodesHealth Catalyst
The transition to ICD-10 in 2015 saw the number of available procedure codes increase from roughly 3,000 to more than 70,000. This change gives clinicians the ability to code procedures to a much higher degree of specificity and provides health systems the ability to unlock powerful clinical insights into how inpatient procedural care is delivered.
This article covers the benefits and drawback of ICD-10 PCS, as well as concrete ways health systems can use these procedure codes to provide new clinical insights. The article also walks through the anatomy of the seven-digit alphanumeric codes and provides specific clinical examples of how healthcare organizations can slice and dice this data.
Lecture on the role of IS/IT in the healthcare domain. Various types of IS/IT are introduced. Also, the benefits of IS/IT in healthcare are outlined. Various developments in healthcare from a hospital CXO perspective are specified. Finally, I will also presentbenefits and costs associated with the implementation of health information technology.
Presentation by David Farber, FDA Life Science Partner at King & Spalding, about US Reimbursement.
I. Introduction
• II. FDA Approval vs. Reimbursement
• a. Different Standards
b. Clinical Evidence Needed
• III. The Three Keys to Reimbursement
A. Coverage
B. Coding
C. Payment
• IV. What’s New for 2019
• V. Reimbursement for MedTech AI Solutions
• VI. Tips for Successful Reimbursement
This presentation was shared with an audience at the AHLA Fundamentals of Health Law program in November 2008.
It contains some basic coding and compliance information to introduce health lawyers to the coding world including recent hot topics under scrutiny.
ICD-10 Transition Presentation: What Health Lawyers Need to KnowPYA, P.C.
PYA Consulting Principal Denise Hall, along with co-presenter Julie Chicoine, recently updated health lawyers about ICD-10 transition readiness at the American Health Lawyers Association Institute on Medicare and Medicaid Payment Issues, held March 26-27, 2014.
Managing transactions on Ethereum with Apache AirflowMichael Ghen
Apache Airflow is a Python-based workflow management system that can be used to actively monitor and execute transactions on blockchain networks like Ethereum. This presentation is an introduction to Apache Airflow followed by a demonstration of a production deployment. Apache Airflow is an excellent tool for anyone already familiar with Python. Its ability to process jobs and handle errors makes it a good choice tool for managing activity on blockchain networks. The goal of this talk is to demonstrate how Apache Airflow can be used for environmental scanning and batch processing transactions. The demonstration will cover using Airflow and Python for monitoring and executing ERC20 token transactions on the Ethereum blockchain.
BDT has moved from SAS-based workflow a cloud-based workflow leveraging tools like BigQuery, Looker, and Apache Airflow. Originally presented at the 2018 Pennsylvania Data Users Conference: https://pasdcconference.org/
AWS Machine Learning abstracts a lot of the complexity of a machine learning solution (e.g. cross-validation, training data set management, algorithm selection, F1-score computation) making it easy to train and deploy machine learning models.
Show drafts
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Empowering the Data Analytics Ecosystem: A Laser Focus on Value
The data analytics ecosystem thrives when every component functions at its peak, unlocking the true potential of data. Here's a laser focus on key areas for an empowered ecosystem:
1. Democratize Access, Not Data:
Granular Access Controls: Provide users with self-service tools tailored to their specific needs, preventing data overload and misuse.
Data Catalogs: Implement robust data catalogs for easy discovery and understanding of available data sources.
2. Foster Collaboration with Clear Roles:
Data Mesh Architecture: Break down data silos by creating a distributed data ownership model with clear ownership and responsibilities.
Collaborative Workspaces: Utilize interactive platforms where data scientists, analysts, and domain experts can work seamlessly together.
3. Leverage Advanced Analytics Strategically:
AI-powered Automation: Automate repetitive tasks like data cleaning and feature engineering, freeing up data talent for higher-level analysis.
Right-Tool Selection: Strategically choose the most effective advanced analytics techniques (e.g., AI, ML) based on specific business problems.
4. Prioritize Data Quality with Automation:
Automated Data Validation: Implement automated data quality checks to identify and rectify errors at the source, minimizing downstream issues.
Data Lineage Tracking: Track the flow of data throughout the ecosystem, ensuring transparency and facilitating root cause analysis for errors.
5. Cultivate a Data-Driven Mindset:
Metrics-Driven Performance Management: Align KPIs and performance metrics with data-driven insights to ensure actionable decision making.
Data Storytelling Workshops: Equip stakeholders with the skills to translate complex data findings into compelling narratives that drive action.
Benefits of a Precise Ecosystem:
Sharpened Focus: Precise access and clear roles ensure everyone works with the most relevant data, maximizing efficiency.
Actionable Insights: Strategic analytics and automated quality checks lead to more reliable and actionable data insights.
Continuous Improvement: Data-driven performance management fosters a culture of learning and continuous improvement.
Sustainable Growth: Empowered by data, organizations can make informed decisions to drive sustainable growth and innovation.
By focusing on these precise actions, organizations can create an empowered data analytics ecosystem that delivers real value by driving data-driven decisions and maximizing the return on their data investment.
Chatty Kathy - UNC Bootcamp Final Project Presentation - Final Version - 5.23...John Andrews
SlideShare Description for "Chatty Kathy - UNC Bootcamp Final Project Presentation"
Title: Chatty Kathy: Enhancing Physical Activity Among Older Adults
Description:
Discover how Chatty Kathy, an innovative project developed at the UNC Bootcamp, aims to tackle the challenge of low physical activity among older adults. Our AI-driven solution uses peer interaction to boost and sustain exercise levels, significantly improving health outcomes. This presentation covers our problem statement, the rationale behind Chatty Kathy, synthetic data and persona creation, model performance metrics, a visual demonstration of the project, and potential future developments. Join us for an insightful Q&A session to explore the potential of this groundbreaking project.
Project Team: Jay Requarth, Jana Avery, John Andrews, Dr. Dick Davis II, Nee Buntoum, Nam Yeongjin & Mat Nicholas
As Europe's leading economic powerhouse and the fourth-largest hashtag#economy globally, Germany stands at the forefront of innovation and industrial might. Renowned for its precision engineering and high-tech sectors, Germany's economic structure is heavily supported by a robust service industry, accounting for approximately 68% of its GDP. This economic clout and strategic geopolitical stance position Germany as a focal point in the global cyber threat landscape.
In the face of escalating global tensions, particularly those emanating from geopolitical disputes with nations like hashtag#Russia and hashtag#China, hashtag#Germany has witnessed a significant uptick in targeted cyber operations. Our analysis indicates a marked increase in hashtag#cyberattack sophistication aimed at critical infrastructure and key industrial sectors. These attacks range from ransomware campaigns to hashtag#AdvancedPersistentThreats (hashtag#APTs), threatening national security and business integrity.
🔑 Key findings include:
🔍 Increased frequency and complexity of cyber threats.
🔍 Escalation of state-sponsored and criminally motivated cyber operations.
🔍 Active dark web exchanges of malicious tools and tactics.
Our comprehensive report delves into these challenges, using a blend of open-source and proprietary data collection techniques. By monitoring activity on critical networks and analyzing attack patterns, our team provides a detailed overview of the threats facing German entities.
This report aims to equip stakeholders across public and private sectors with the knowledge to enhance their defensive strategies, reduce exposure to cyber risks, and reinforce Germany's resilience against cyber threats.
1. Decoding Health Care Codes:
ICD-10, DRG, CPT, HCPCS
Chicago Technology for Value-based Healthcare
2. Scope of this presentation
What’s included:
For each code, this presentation will answer:
● Who created it
● Who maintains it
● Where is it found
● What does it look like
Please speak up if you have questions
or experience with coding you can
share
What’s not included but worth noting
important:
● Limitations within the codes
● In depth information about how codes relate,
translate, encode and decode meaning
● How coding impact payer and provider
financing
Where does information from this presentation
come from?
● Wikipedia
● CMS
● AMA
3. Why do we code?
● There is a massive amount of
data created for each episode of
care:
● Very specific information
○ Example DRG code:
Intracranial hemorrhage or
cerebral infarction with CC
or tPA in 24 hours
● Uniform documentation between
medical facilities
○ Interoperability
● To get paid properly
○ UB-40 form
Image Source: http://www.outsourcestrategies.com/medical-billing-outsourc ing.htm
4. Decoding
Health Care
Codes
International Statistical Classification
of Diseases and Related Health
Problems (ICD-10)
Diagnostic Related Groups (DRG)
Current Procedural Terminology (CPT)
Healthcare Common Procedure
Coding System (HCPCS)
5. Decoding
Health Care
Codes
International Statistical Classification
of Diseases and Related Health
Problems (ICD-10)
Diagnostic Related Groups (DRG)
Current Procedural Terminology (CPT)
Healthcare Common Procedure
Coding System (HCPCS)
6. International Statistical Classification of
Diseases and Related Health Problems (ICD)
● Who created it? Who maintains it?
○ World Health Organization, countries have their
own versions. In the US, CMS has ICD-10-CM and
ICD-10-PCS. CMS contracted with 3M to develop
ICD-10-PCS
● Who uses it? What is it for?
○ UK, Sweden and Brazil all adopted ICD-10 before
2000
○ US adopted it in Oct. 2015
○ Used for classifying:
■ disease states
■ signs and symptoms
■ abnormalities
■ procedures Image source:
https://www.aapc.com/medical-coding-books/2016/2016-icd-10-pcs-book.aspx
7. International Statistical Classification of
Diseases and Related Health Problems (ICD)
● Where is it found?
○ EMR systems, billing
■ Codes for reasons for
visits in all American
health care settings
● What do ICD10 codes look like?
○ 7 digit, mix of letters and
numbers
○ The position of the digit has
significance (e.g. Indicate a
part of the body)
○ Don’t always expect a
decimal point
Image Source: http://www.mtuitive.com/synoptic-reporting-can-solve-icd-10-woes/
8. Technologies
● IT systems using ICD:
○ EDW and Business
intelligence
○ Clinical documentation
○ Electronic data interchange
○ Computer assisted coding
○ Revenue cycle management
● Example solutions:
○ Aqua.io: code conversion API
○ Computer assisted coding
Image source: http://hitconsultant.net/2015/02/17/computer-assisted-coding-market-expected-to-reach-3-5b-by-2019/
9. Decoding
Health Care
Codes
International Statistical Classification
of Diseases and Related Health
Problems (ICD-10)
Diagnostic Related Groups (DRG)
Current Procedural Terminology (CPT)
Healthcare Common Procedure
Coding System (HCPCS)
10. Diagnostic Related Groups (DRG)
● What is it for?
○ statistical system of classifying
any inpatient stay into groups
for the purposes of payment
○ intended to identify the products
that a hospital provides
● Who uses it?
○ Medicare uses it for
reimbursements
○ Countries develop their own
DRG version (i.e. SwissDRG)
● Who created it?
○ Professors from Yale
Image Source: http://www.slideshare.net/stefanst/introduction-to-swissdrg-english
11. Diagnostic Related Groups (DRG)
● Where is it found?
○ Medical billing
○ Many versions:
■ Medicare DRG (CMS-DRG &
MS-DRG)
■ Refined DRGs (R-DRG)
■ All Patient DRGs (AP-DRG)
■ Severity DRGs (S-DRG)
■ etc.
● What do the codes look like?
○ 3 numeric digits
○ High level code, MDC codes offer
more granularity
○ Examples: CMS Index
○ ICD-10 codes fall into a DRG
12. Decoding
Health Care
Codes
International Statistical Classification
of Diseases and Related Health
Problems (ICD-10)
Diagnostic Related Groups (DRG)
Current Procedural Terminology (CPT)
Healthcare Common Procedure
Coding System (HCPCS)
13. Current Procedural Terminology (CPT)
● Who created it? Who maintains it?
○ Maintained by AMA
○ Copyrighted, you need to license it from AMA
■ Pay AMA a fee
● Who uses it? What is it for?
○ the code set used to bill outpatient and office
procedures
○ Similar to ICD10
○ It identifies the services rendered rather than
the diagnosis on the claim
“the use of the code is
mandated by almost all
health insurance payment
and information systems,
including the Centers for
Medicare and Medicaid
Services (CMS) and HIPAA,
and the data for the code
sets appears in the Federal
Register.”
14. Current Procedural Terminology (CPT)
● Where is it found?
○ Insurance claims
● What do ICD10 codes look like?
○ Category 1: Numeric, 5-digits
○ Category 2: Alphanumeric, 4-digits,
5th is a character (i.e. F)
■ clinical components usually
included in evaluation and
management or clinical services
and are not associated with any
relative value
○ Category 3: Alphanumeric, 4-digits,
5th is a character (i.e. T)
■ Emerging technology
Image source: https://www.mtnmedical.com/physician/cpt-codes-mri.php
15. Decoding
Health Care
Codes
International Statistical Classification
of Diseases and Related Health
Problems (ICD-10)
Diagnostic Related Groups (DRG)
Current Procedural Terminology (CPT)
Healthcare Common Procedure
Coding System (HCPCS)
16. Healthcare Common Procedure Coding System (HCPCS)
● Who created it? Who maintains it?
○ Developed by the CMS
○ Maintained by the AMA
● Who uses it? What is it for?
○ Covers services, procedures, and equipment not covered by CPT codes
■ durable medical equipment
■ prosthetics
■ ambulance rides
■ certain drugs and medicines
○ Superset of CPT codes
17. Healthcare Common Procedure Coding System (HCPCS)
● Where is it found?
○ official code set for
outpatient hospital
care, chemotherapy
drugs, Medicaid, and
Medicare, among other
services
○ HIPAA mandated
● What do HCPCS codes look
like?
○ Level 1: CPT codes
○ Level 2: 5-digits,
alphanumeric
Image Source: http://heartlandtrc.org/2013-telehealth-codes/