What is the difference between ICD, CPT, and HCPCS codes?

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ICD, CPT, and HCPCS are key medical coding systems, each serving a distinct purpose in healthcare documentation and billing:

1. ICD (International Classification of Diseases)

• Purpose: Codes diagnoses, diseases, and health conditions.

• Maintained by: World Health Organization (WHO).

• Usage: Used worldwide for reporting patient diagnoses and morbidity statistics.

• Example: ICD-10 code I10 for essential (primary) hypertension.

• Focus: What’s wrong with the patient (diagnosis).

2. CPT (Current Procedural Terminology)

• Purpose: Codes medical procedures and services performed by healthcare providers.

• Maintained by: American Medical Association (AMA).

• Usage: Primarily in the U.S. for billing physician services, surgeries, lab tests, and office visits.

• Example: CPT code 99213 for a standard outpatient office visit.

• Focus: What the healthcare provider did for the patient (procedure/service).

3. HCPCS (Healthcare Common Procedure Coding System)

• Purpose: Extends CPT codes by covering non-physician services, supplies, equipment, and procedures.

• Levels:

  • Level I: Identical to CPT codes.

  • Level II: Codes for items like ambulance rides, durable medical equipment, prosthetics.

• Usage: Used mainly in U.S. Medicare/Medicaid billing.

• Example: HCPCS code E0114 for crutches.

• Focus: Items and services not included in CPT.

In essence, ICD tells what the patient has, CPT describes what was done, and HCPCS covers additional services and supplies.

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