01 Dec Coding Standards: What Are CPT Codes, ICD Codes, LOINC Codes, and SNOMED CT Codes?
Everyone encounters medical coding standards at some point. This is true for medical professionals, medical billers, and patients. Whether you are a physician or a patient, understanding the answer to such questions as “What are CPT codes?” and “How do they differ from ICD codes?” is vital to ensure proper health care. Here’s everything there is to know about medical coding standards.
ICD Codes: International Classification of Disease
The International Classification of Disease (ICD) is a database of recorded diagnoses used across medical practices. The World Health Organization (WHO) founded, monitors, and owns this database. The database uses codes to identify symptoms, causes of death, and diagnoses. Medical professionals across the U.S. use the same codes to identify and interpret medical records.
CPT Coding: Current Procedural Terminology
The American Medical Association (AMA) maintains and owns the CPT code database. This database contains all the codes used for medical procedures. Just like the ICD database, this database allows medical professionals across the U.S. to communicate with each other and the medical records. Because of the similarities between ICD codes and CPT codes, many confuse the two. CPT codes identify the services a medical professional provides, and ICD codes identify the diagnosis of a patient. Insurance providers use CPT codes to determine how many medical professionals get paid for their care.
CPT 99499 is an example of a CPT code. This code falls under “other evaluations and management services.” With this code in a medical record, the insurance provider understands what services a patient received and what kind of payment the medical professional who provided the car should receive.
CPT codes consist of five characters, which can be numeric or alphanumeric. With ICD codes, each character in the code corresponds to something specific. This is not true of CPT codes. Instead, it is the entire code (all five characters combined) that identify what the code means. CPT codes within the database are flexible, so they can change over time.
LOINC: Logical Observation Identifiers Names and Codes
Regenstrief Institute created LOINC codes back in 1994 as a universal code database for clinical and laboratory observation. This database made transferring health records across different systems a lot easier. These codes identify patient test observations. This type of code is more specific than CPT codes. For example, a CPT code can include several LOINC codes. Statistically, this type of coding database is not as common as CPT and ICD codes.
The purpose of medical codes, such as CPT and ICD, is to organize medical records and keep information concise. The codes offer a uniformity that is necessary to keep medical practices running smoothly. Medical practice owners should take the time to train and retrain staff members to use codes properly to ensure the smooth operation of the practice. Not using the codes properly can not only create a medical billing error but also put the life of a patient at risk.