The CPT and ICD-9
The CPT and ICD-9
CPT stands for current procedural terminology codes, which are numbers assigned to every service and task a medical clinician, may offer to a patient. These services include diagnostic, surgical and medical services. The insurers then use those services to determine the amount of compensation that a clinician will get from the insurer. Since everybody uses the same codes to signify the same thing, hence they ensure equivalence. The CPT codes get developed and maintained by American Medical Association (AMA). Furthermore, AMA does update the codes annually to ensure continuity in CPT developments every year.
ICD-9 stands for (International Classification of Diseases volume 9code). This coding is an arithmetical system that organizes injuries and diseases into groups in accordance to established criteria or pattern. Most of the ICD-9 Codes are numeric consisting of three, four or five numbers as an explanation or description.
The examples of CPT Codes:
Diagnosis -code 90658 indicates a flu shot
-code 99214 can be used for a physical
-code 90716 may be used for chicken pox vaccine
-code 90396 may be used for physical check up
-Code 12002 indicates stitching one-inch cut on a patients arm
The examples of ICD-9 Codes:
Diagnosis Code- 307.81 may be used for tension headache
Code-346.10 Common migraine without intractable migraine
Code-784.0 Headache
Code- 7240.1 pain in the thoracic spine
Code-847.1 Sprains and strains of thoracic
Code-848.3 Sprains and strain of ribs (Land mark healthcare and Chirocare, 2012)
The use of medical codes in the medical arena:
There are several uses of medical codes depending on the code use and purpose. Sources argue that all codes relate to each other. Although the codes will be the same, sometimes there are extra numbers or letters attached to them for different uses. This extra letters or numbers help in differentiating various uses of the codes. ICD-9 code for tension headache diagnoses is 307.81this code is differentiated from Headache diagnosis by the code 784.0 through the codes attached. For example, ICD code number can be added CM (clinical modification) for purposes of differentiating the service from other services.
Clinical modifications get used in hospitals and other facilities to illustrate any health challenges a patient has from symptoms to diagnosis up to outcome or results from treatment, as well, as, the causes of death. These codes will continue to be used even in the other functions other than medical uses. Furthermore, as we move more and more electronic the medical records will be electronically generated; hence helping the clinicians, as well as, other professionals. Some codes such as ICD get used by the government in tracking down certain illness, especially those that are extremely infectious or those that have civic heath interest such as HIV and Breast cancer, get tracked by the authorities to assist in ascertaining how the spread, where they are rampant, and possibly to help budget research or programs to work on prevention. On the other hand, ICD codes get used in describing the cause of death on several patients. In most cases, the codes get added on the death certificate to explain the cause of a patient’s death. These codes help the health authorities to track and identify the cause of someone’s death. Medical codes (CPT) are also used in determining the amount of compensation that a medical practitioner will get by an insurer.
The ICD-9 assigns a unique code to the diagnosis of the disease or condition being diagnosed. This gets to be a homogeneous or uniform so that patients and the doctors can comprehend what gets diagnosed in the patient encounter. The ICD-9 comes in three volumes. In most cases, volume two and one are the same, although volume one gets planned in alphabetical order and volume two gets arranged by systems. In addition, volume three contracts with surgical codes and is not pertinent to doctors of oriental medicine. The CPT gets to be a listing of descriptive terms used in recognizing codes for reporting medical services and dealings performed by doctors. The main purpose of the terminologies get to be to identify a uniform language that will be accurately describe the diagnostic and treatment services; hence providing the uniform language of communicating between physicians, patients and insurance companies.
The CPT code should get up dated in 3 to 5 years. The AMA has the mandate to renew the codebook since it is permitted by the authorities to make time to time CPT changes up dates. In a concise description one can say that, CPT gets to be the code used to describe the diagnosis or treatment services offered for that particular treatment. On the other hand, IDC-9 gets to be the description of a disease or condition being diagnosed also identified as treatment. Furthermore, IDC-9 is used by the physicians as identification of the diagnosis on a patient who succumbed. The code is usually attached or added on the deceased death certificate (McNamee K, 2001). In addition, other sources affirm that ICD-9 provides statistical classification that organizes injuries and diseases into groups according to established methods.
Reference:
McNamee K, (2001) Insurance Billing: What’s the difference between ICD-9 and CPT? Acupuncture today Vol. 02 issue 10
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