Medical coding is the process of translating healthcare diagnoses, procedures, medical services, and equipment into universal alphanumeric codes. These codes are taken from medical record documentation such as physician’s notes, lab reports, and radiologic results.

The main goal is to ensure accurate documentation and billing for healthcare services provided to patients.

Overview of CPT, ICD-10, and HCPCS Codes

1. ICD-10 (International Classification of Diseases, 10th Revision):

   • Used to classify diagnoses and medical conditions.

   • Example: ICD-10 Code J45.909 = Unspecified asthma, uncomplicated.

2. CPT (Current Procedural Terminology):

   • Describes medical, surgical, and diagnostic services.

   • Maintained by the American Medical Association (AMA).

   • Example: CPT Code 99213 = Office visit for an established patient.

3. HCPCS (Healthcare Common Procedure Coding System):

   • Used mainly for Medicare and Medicaid billing.

   • Covers services not included in CPT, such as ambulance rides, durable medical equipment, and supplies.

   • Example: HCPCS Code E0110 = Crutches, underarm.

Importance in Healthcare Billing

• Ensures accurate reimbursement for healthcare providers.

• Helps in claim processing by insurance companies.

• Maintains medical record consistency and supports data analysis and public health reporting.

• Reduces billing errors and fraud.

Medical coding is essential in the healthcare revenue cycle and helps bridge the gap between healthcare providers and payers (insurance companies).

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