ICD-9 vs. CPT Codes: Understanding Medical Coding for Billing & Documentation

The Centers for Disease Control and Prevention (CDC), defines ICD-9-CM codes as a means of classifying data related to diseases and symptoms. The coding system is used across the board--from doctors' offices to inpatient and outpatient settings. Current Procedural Terminology, or CPT codes, are a system of codes developed and maintained by the American Medical Association (AMA) for the classification of medical services and procedures. CPT codes are essential for medical insurance purposes. Health insurance companies can deny claims if the ICD-9-CM code is not linked to the appropriate CPT code to show the reason a procedure was performed.

Things You'll Need

• Patient chart
• HCFA claim form

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Instructions

• 1

  Obtain the patient's chart from the physician. Review the chart carefully, including the reason for the visit, the diagnosis and any treatments performed or tests ordered.

• 2

  Record the correct ICD-9-CM code for diagnosis on line 21 of the HCFA form.

• 3

  Add the CPT numbers for procedures in box 24 of the form, lines 1 through 6.

• 4

  In column E of box 24, repeat the ICD-9-CM diagnosis code you recorded on line 21. This shows the direct link between a procedure or treatment and a diagnosis.