What is the difference between CPT and ICD 9 procedure codes?
Asked by: Asa Bahringer | Last update: December 10, 2025Score: 4.7/5 (20 votes)
What is the difference between CPT and ICD codes?
While CPT codes are similar to ICD-10 codes, CPT codes identify services rendered, whereas ICD-10 codes represent patient diagnoses.
What is the difference between CPT coding and ICD coding?
CPT® codes, or Current Procedural Terminology codes, are a standardized system used to describe the specific services and procedures provided to a patient. Unlike ICD-10 codes, which identify the diagnosis or medical condition, CPT® codes focus on documenting the what—that is, the treatment or service delivered.
What is the difference between a procedure code and a diagnosis code?
CPT codes are numeric codes that are used to describe medical procedures and services. DX codes are used to report the diagnosis of a patient's condition.
What is an ICD-9 procedure code?
ICD-9-CM is the official system of assigning codes to diagnoses and procedures associated with hospital utilization in the United States. The ICD-9 was used to code and classify mortality data from death certificates until 1999, when use of ICD-10 for mortality coding started.
Introduction to ICD-9 and ICD-10
What is the difference between a CPT code and an ICD-9 code?
The ICD-9-CM codes are for the disorder or disorders you are treating while the CPT codes are for reporting the procedure or procedures you performed. The ICD-9-CM is coordinated and maintained by the federal government while the AMA maintains and updates the CPT codes.
What are the two types of ICD codes?
The International Classification of Diseases (ICD) is a standardized system used to code causes of death (mortality) data from death certificates. The International Classification of Diseases, Clinical Modification (ICD-CM) is a standardized system used to code diseases and medical conditions (morbidity) data.
Are CPT and procedure codes the same?
The ICD-10 procedural coding system (ICD-10-PCS) is used by facilities (e.g., hospital) to code procedures. CPT codes are, and will continue to be, used by physicians (and other providers) to report professional services. The two systems are unique and very different.
How do CPT and ICD coding work together?
CPT and ICD codes are at the heart of medical coding. When a healthcare provider submits a claim to an insurance company or other payer for reimbursement, they must include the appropriate ICD code(s) to indicate the patient's diagnosis and the CPT code(s) to convey the procedures and services performed.
What are the three types of procedure codes?
- Category I: These codes have descriptors that correspond to a procedure or service. ...
- Category II: These alphanumeric tracking codes are supplemental codes used for performance measurement. ...
- Category III: These are temporary alphanumeric codes for new and developing technology, procedures and services.
Why do we code patient visits with ICD and CPT codes?
These codes assist in relaying significant information about your patients' diagnoses, treatments, and procedures to insurance companies, government agencies, and other healthcare providers.
What is an example of a CPT code?
Here are some examples of CPT codes: 99397 can be used for a preventive exam if you are over age 65. 90658 can be used for the administration of a flu shot. 90716 can be used for the administration of the chickenpox vaccine (varicella).
Are ICD codes used for billing?
ICD codes are used in billing, treatments, and statistics collection. Having the right code is important to ensure that standardized treatment for a medical issue is delivered and that medical expenses are reimbursed.
What is the main difference between ICD-9 and ICD-10 coding?
The ICD-10 code sets are not simply increased and renumbered ICD-9 code sets. The move to ICD-10 will not be easy. The ICD-10 code sets include greater detail, changes in terminology, and expanded concepts for injuries, laterality, and other related factors.
Is ICD a procedure code?
ICD-10-PCS is a procedure classification published by the United States for classifying procedures performed in hospital inpatient health care settings.
What are the two main coding systems?
Two common medical coding classification systems are in use — the International Classification of Diseases (ICD) and the Current Procedural Terminology (CPT).
How do CPT codes differ from ICD-9 codes?
To differentiate between these coding systems, think of it this way: CPT codes describe what you do, and ICD-9 codes describe why you do it. Each service you provide becomes a line item (a CPT code) on an insurance claim form.
What's the difference between CPT and ICD codes?
The two codes go hand in hand in conveying your work in a therapy session, but they play a different role in the billing process. While ICD-10 codes indicate your client's diagnosis, or why you're billing the payer, CPT codes convey the service for which you're billing.
Who do CPT and ICD codes act as the universal language between?
Clear communication is very important in healthcare. Medical coding systems act as a universal language, enabling healthcare providers, insurance companies, and researchers to work together seamlessly.
What is the key purpose of ICD coding?
The ICD is important because it provides a common language for recording, reporting and monitoring diseases. This allows the world to compare and share data in a consistent and standard way – between hospitals, regions and countries and over periods of time.
Which diagnosis code type can never stand alone?
(option C) An external cause code in medical diagnosis can not stand alone because it describes circumstances leading to a health condition and should be used with other codes.
What is an ICD diagnosis code?
International Classification of Diseases, Tenth Revision (ICD-10) is a system used by physicians to classify and code all diagnoses, symptoms and procedures for claims processing. It was chiefly designed by the World Health Organization, with the U.S. version being created by the Centers for Medicar.
What is an ICD-9 code?
The current diagnosis coding system used in the United States is International Classification of Diseases (ICD)-9-Clinical Modification (CM), which has an alphabetic index (Volume 2) and a tabular index (Volume 1). The ICD-9-CM system is used in all venues of healthcare to report diagnoses.
What is the difference between CPT code and procedure code?
The CPT codebook is a procedure coding system and is used when coding for physicians or outpatient facilities. These codes will be used directly on claim forms to third party payers for reimbursement. The ICD-10-PCS codes are also used procedure coding, however, they are used only for inpatient facilities.
What does code grey mean in a hospital?
A hospital may use code gray if someone, including a patient, is being aggressive, abusive, or violent. Security personnel can assist other hospital staff to resolve the situation or remove the person from the premises if necessary.