What is the difference between CPT code and procedure code?
Asked by: Regan Heathcote | Last update: October 2, 2025Score: 4.3/5 (75 votes)
Is a CPT code the same as a procedure code?
For some types of care, procedures are billed using CPT (Current Procedural Terminology) /HCPCS (Healthcare Common Procedure Coding System) codes, rather than ICD. CPT codes, also called Level I HCPCS codes, are used to bill physician services and they are copyrighted by the American Medical Association (AMA).
Are CPT codes the same as ICD-10 procedure codes?
While CPT codes are similar to ICD-10 codes, CPT codes identify services rendered, whereas ICD-10 codes represent patient diagnoses.
What do you mean by procedure code?
Procedure codes are a sub-type of medical classification used to identify specific surgical, medical, or diagnostic interventions. The structure of the codes will depend on the classification; for example some use a numerical system, others alphanumeric.
What is an example of a CPT procedure 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).
The Difference Between HCPCS and CPT Codes
How do I find the procedure code for a CPT?
The American Medical Association (AMA) maintains the CPT code set. Innovators can begin a general search for an appropriate CPT code online by initiating a general online search.
What is the CPT code 90837?
For CPT code 90837 (psychotherapy, 60 minutes with patient), a physician or other qualified health care professional can report a prolonged service code if the psychotherapy service, not performed with an E/M service, is 90 minutes or longer involving direct patient contact.
What is an example of a procedure in code?
A procedure performs a task and does not necessarily return any values, where are a function would return values for elsewhere in the program to use. For example a procedure might be to draw a square, a function might be to ask the user their name and return the result in a string.
Is an ICD-10 code a procedure code?
ICD-10 consists of codes for diagnoses and hospital inpatient procedures.
What procedure code is 99213?
CPT® code 99213: Established patient office visit, 20-29 minutes | American Medical Association.
Is procedure code same as Hcpcs code?
HCPCS stands for Healthcare Common Procedure Coding System and is used to classify medical procedures and services. Meanwhile, CPT, or Current Procedural Terminology, is used to describe medical procedures and services.
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 many CPT codes are there?
There are currently over 10,000 CPT codes in medical terminology. However, this figure changes every year due to new codes being added and obsolete ones being removed. In 2023, the AMA conducted 393 editorial changes to the current set, with 225 new codes being added, 93 being revised, and 75 being deleted altogether.
What is another name for the CPT code?
The first publication, in 1966, of the American Medical Association (AMA) Current Procedural Terminology (CPT®) edition of standardized codes and terms was a means to code procedures (mainly surgical) for medical records, insurance claims, and information for statistical purposes.
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 a procedure code for medical services?
CPT® refers to a set of medical codes used by physicians, allied health professionals, nonphysician practitioners, hospitals, outpatient facilities, and laboratories to describe the procedures and services they perform.
Is a procedure code a CPT code?
The Current Procedural Terminology (CPT®) codes offer doctors and health care professionals a uniform language for coding medical services and procedures to streamline reporting, increase accuracy and efficiency.
What is the difference between CPT and ICD-10 procedure 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.
What is an example of a procedure code?
What is an example of a procedure code? Let's consider an example of a medical procedure code for insurance: CPT code 99213. This code represents an Evaluation and Management (E&M) service provided by a physician or qualified healthcare professional.
What does it mean to call a procedure coding?
A 'Procedure Call' refers to the process of invoking a procedure in a program, which involves a precall sequence and a postreturn sequence in the caller, as well as a prologue and an epilogue in the callee.
What is an example for CPT code?
CPT codes are, for the most part, grouped numerically. The codes for surgery, for example, are 10021 through 69990. In the CPT codebook, these codes are listed in mostly numerical order, except for the codes for Evaluation and Management.
What are two examples of procedure?
Examples of procedure in a Sentence
Installing a car battery is a simple procedure. What is the procedure for applying for a loan? New employees are taught the proper safety procedures.
Is 90834 a procedure code?
CPT Code 90834 is the most common procedure code used in mental health and behavioral health billing. In our guide, you'll learn how to bill 90843, the differences between procedure codes 90834 and 90837, the 2025 reimbursement rate for 90834, which add-on codes to use, and how to code your claims for 90834.
What does CPT stand for?
Current Procedural Terminology (CPT®) codes provide a uniform nomenclature for coding medical procedures and services.
What is the CPT code 99213?
CPT 99213 specifically describes a moderate-complexity office or outpatient visit. This code applies only to established patients—those who have previously been seen by the practitioner or another provider within the same group practice within the last three years.