1. A Breakdown of ICD, CPT, and HCPCS
Medical Coding
A Breakdown of ICD, CPT, and HCPCS

2. What is Medical Coding?
The process of transforming descriptions of medical diagnosis and procedures into universal medical code numbers
Diagnosis codes track diseases and other health conditions
Procedure codes track interventions performed

3. ICD 10 Broken down into two components ICD-10-CM
All providers use it in U.S. health care settings
Codes are based on documentation in the patients medical record
Centers for Disease Control (CDC) develop and maintain codes.
ICD-10-PCS
Used to report procedures performed in U.S. Hospitals
Codes are also based on documentation in the patient’s record
CMS developed and maintains

4. HCPCS Level I codes and modifiers are the CPT codes
Level II codes and modifiers are designated for products, supplies and services not included in CPT codes
Examples:
Drugs
Ambulence fees
Orthotics
Durable medical Equipment

5. CPT Codes
Used to report procedures and services in outpatient/ambulatory settings
Codes are developed by the American Medivdical Assosiation

6. Level II HCPCS
Codes used to report supplies, procedures, and cetainprofessonal services notdescribed in the CPT
CMS maintains the vode set
D-Codes are an exception as they are maintained by the American dental Assosiation

7. Impact of Incorrect Coding
The switch from ICD-9 to ICD-10 has made coding more difficult
Codes are now much more descriptive than in previous years
A failure to code correctly could affect a patients treatment
Just one instance of incorrect can cost a facility million of dllars
Consequency could be fines or considered n making the error a legal issue