Coding
HCPCS
- Level II codes maintained by CMS
- alphanumeric medical diagnostic codes
- primarily non-physician services: ambulance, prosthetics
- items, supplies and non-physician services not covered by CPT-4 codes (Level I)
- one letter in the range A to V followed by 4 digits
“The Healthcare Common Procedure Coding System (HCPCS, often pronounced by its acronym as “hick picks”) is a set of health care procedure codes based on the American Medical Association‘s Current Procedural Terminology (CPT).” – https://en.wikipedia.org/wiki/Healthcare_Common_Procedure_Coding_System
ICD-9 and ICD-10 – International Classification of Disease
https://en.wikipedia.org/wiki/ICD-9#ICD-9
- Sponsored by WHO
- Codes up to 6 characters
- 3 character minimum
- if there are more specific sub-codes, the 3-digit code will be in boldface followed by subsequent numbers
- Diagnosis-based
RVS – Relative Value System codes
- Created by insurers
- Evolved into CPT
CPT-4 – Current Procedural Terminology (CPT)
- Owned by AMA
- Equals HCPCS Level 1
- 5-digit codes plus modifiers
“The Current Procedural Terminology (CPT) code set is a medical code set maintained by the American Medical Association through the CPT Editorial Panel … CPT coding is similar to ICD-9 and ICD-10 coding, except that it identifies the services rendered rather than the diagnosis on the claim. ICD code sets also contain procedure codes but these are only used in the inpatient setting.” – https://en.wikipedia.org/wiki/Current_Procedural_Terminology
MSDRG
A system of Medicare diagnosis groupings using medical codes to define Medicare compensation.
National Codes
- Created for CMS
- for billing procedures and supplies for Medicare patients
- Widely used by insurers