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What are medical codes for billing?

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Quick Answer

Medical billing codes identify procedures, diagnoses and certain devices or equipment involved in the delivery and billing of health care services. The three major coding sets involved in medical billing are Current Procedural Terminology, Healthcare Common Procedures Coding System and International Classification of Diseases, 9th Revision, Clinical Modification.

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What are medical codes for billing?
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Full Answer

Current Procedural Terminology codes are five-digit numerical codes that represent specific services a patient may receive from a health care provider. These codes are created and maintained by the American Medical Association. CPT codes promote standardization of billing among the health care community and determine the amount of reimbursement a health care provider may receive from an insurance company.

Healthcare Common Procedures Coding System codes are alphanumeric codes that report supplies, devices and equipment delivered to patients. Additionally, some procedures not elsewhere classified in the CPT set are included. HCPCS codes are regulated by the Centers for Medicare and Medicare Services.

Finally, the International Classification of Diseases, 9th Revision, Clinical Modification is a set of three-digit codes followed by a decimal point that is reported to an insurance company. It specifies diagnoses and disorders that a patient was treated for. ICD-9-CM is regulated by the National Center for Healthcare Statistics. ICD-9 codes are reported in conjunction with CPT and HCPCS codes to ensure accurate health care billing.

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