Difference Between CPT and ICD Codes

CPT vs ICD Codes

Getting sick can be costly. That’s why most people have acquired medical or health insurance for themselves and their families. With health insurance, they get a cheaper and more convenient way to get their ailments treated.

Not only are the patients and the doctors involved in the treatment and the diagnosis of a medical problem but also the medical insurers. To hasten the payment process and to make everyone understand the medical problem, manual codes are provided.

There are two manual codes used by medical billers and insurers: the Current Procedural Terminology (CPT) and International Classification of Diseases (ICD).

The CPT book has codes for reporting medical procedures and services such as diagnostic, laboratory, radiology, and surgical. It describes what was done to the patient during the consultation and the procedure code can be found in the CPT book. It describes the medical services and procedures done by the physician. It aims at providing a uniform language to describe the treatment and diagnostic procedures performed and aid in the communication between doctors, patients, and insurance companies.

The ICD book has codes that identify a diagnosis and describe a disease or medical condition. After diagnosing what is wrong with a patient, a physician will assign a diagnosis code which can be found in the ICD-9 or ICD-10 book. It describes the medical condition or disease that is being treated so that all parties involved; the doctor, patient, and insurer will understand better the disease which is being treated.

The CPT book is published by the American Medical Association and has 7,800 codes. The ICD book is published by the World Health Organization and has 24,000 codes for its ICD-9 and more than 200,000 codes for its ICD-10. The CPT book has a health care common procedure coding system and focuses on medications and equipment for which a patient is billed. This system is not found in the ICD book.

CPT codes are more complex than ICD codes. While for a certain ailment a diagnosis may only have one code, to determine the code in the CPT coding would involve determining the circumstances of the patient’s visit to the physician, the time the doctor spent with the patient, how many body systems he examined among other concerns.

ICD books have to be updated every 10 to 15 years while CPT books every 3 to 5 years. Medical billers and health insurance companies should have both books.

Summary:

1.Current Procedural Terminology (CPT) is a medical code manual published by the American Medical Association while the International Classification of Diseases (ICD) is a medical code manual published by the World Health Organization.
2.The CPT code describes what was done to the patient during the consultation, including diagnostic, laboratory, radiology, and surgical procedures while the ICD code identifies a diagnosis and describes a disease or medical condition.
3.CPT codes are more complex than ICD codes.
4.The CPT book is updated every three to five years while the ICD book is updated every 10 to 15 years.

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