What is the difference between CPT and ICD codes?

Asked by: Prof. Prince Gerhold I  |  Last update: March 26, 2025
Score: 4.3/5 (1 votes)

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 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 the difference between CPT and ICD-9 procedure codes?

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.

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.

Differences in CPT, ICD-10-CM and ICD-10-PCS Coding

16 related questions found

What is the difference between CPT code and ICD-10 code?

While CPT codes are similar to ICD-10 codes, CPT codes identify services rendered, whereas ICD-10 codes represent patient diagnoses. (For additional information on ICD-10 codes, please refer to the ICD-10: Understanding the Basics document).

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.

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 two types of CPT codes?

There are various types of CPT 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.

What is the difference between ICD Hcpcs and CPT?

ICD-10-CM diagnosis codes provide the reason for seeking health care; ICD-10-PCS procedure codes tell what inpatient treatment and services the patient got; CPT (HCPCS Level I) codes describe outpatient services and procedures; and providers generally use HCPCS (Level II) codes for equipment, drugs, and supplies for ...

What is the difference between CPT codes and C codes?

Key Differences between HCPCS and CPT

CPT codes are used to report medical, surgical, and diagnostic services performed by healthcare professionals. HCPCS codes are used to report medical procedures and services to Medicare, Medicaid, and other health insurance programs.

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.

Is diagnosis code same as ICD code?

The diagnosis code lists are derived from ICD-10 diagnosis codes that CMS posts each year so that providers and suppliers utilize the applicable diagnosis codes when submitting medical claims to Medicare.

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 does ICD stand for?

International Classification of Diseases (ICD) International Classification of Diseases (ICD) Used to code and classify cause-of-death data. ICD is developed collaboratively by the World Health Organization and 10 international centers, one of which is housed at the National Center for Health Statistics (NCHS).

What is a CPT code?

Current Procedural Terminology (CPT®) codes provide a uniform nomenclature for coding medical procedures and services. Medical CPT codes are critical to streamlining reporting and increasing accuracy and efficiency, as well as for administrative purposes such as claims processing and developing guid.

What is the T code in medical coding?

T codes are another term for Category III codes. Meaning, T codes represent temporary services, technologies, or procedures. These codes are made up of 5 characters — 4 digits followed by the letter T.

What is the CPT code 99214?

CPT® code 99214: Established patient office visit, 30-39 minutes.

What is the difference between ICD-10 and CPT?

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.

What is the difference between a CPT code and an ICD 9 code Why would you need both?

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.

How do you code in ICD?

A Five-Step Process
  1. Step 1: Search the Alphabetical Index for a diagnostic term. ...
  2. Step 2: Check the Tabular List. ...
  3. Step 3: Read the code's instructions. ...
  4. Step 4: If it is an injury or trauma, add a seventh character. ...
  5. Step 5: If glaucoma, you may need to add a seventh character.

Who sets ICD codes?

CDC's National Center for Health Statistics (NCHS) is responsible for the clinical modification of ICD-10 for use in the United States. The World Health Organization (WHO), which owns and publishes ICD-10, authorized NCHS to develop ICD-10-CM.

Is ICD considered surgery?

An implantable cardioverter defibrillator (ICD) is a medical device that's surgically placed under the skin on your chest. It consists of a battery and thin wires called leads. The battery is about the size of a stopwatch and the leads go into your heart chambers to regulate your rhythm.

How do you explain ICD codes?

The first three characters represent the type of disease or health condition. There is a period or decimal point after the first 3 characters. The next 3 characters after the period can give more details like the cause of the disease, how severe it is, or where it is in the body.