Know About Icd And Cpt Coding

Published: 19th March 2010
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Know about ICD and CPT Coding

ICD: - International Classification of Diseases, Clinical Modification (ICD-9-CM). The ICD-9-CM is maintained jointly by the National Center for Health Statistics (NCHS) and the Centers for Medicare & Medicaid Services (CMS).
CPT: Current Procedural Coding System
HCPCS: Healthcare Common Procedural Coding System Supplies and Drugs Coding
The Coding should be accurate, correct coding leads to proper reimbursement. Upcoding is considered as fraud and downcoding leads to underpayment.
Proper undetsanding of Medical coding, medical billng and HIPAA is must for all billers for the appropiate reimbursement.
You can get plenty of information oover the net, broswe and analyse.

ICD Codes updates Cotober 1st every year
CPT codes updates Jan 1st every year.
HCPCS, jan 1st every year.

E- Codes: Supplemental classification of external causes of injury and poisoning [E800-E990]. E codes capture how the injury or poisoning happened or cause the intent unintentional or accidental or accidental, or intentional, such as suicide or assault and the place where the event occurred.

Some major categories of E codes include

* Transport accident
* poisoning and adverse effects of drugs, medicinal substances and biologicals
* Accidental falls
* Accidents caused by fire and flames
* Accidents due to natural and environmental factors.
* Late effects of accidents, assaults or self injury
* Assaults or purposely inflicted injury
* Suicide or self inflicted injury

Examples:

1. Musculoskeletal system, general

Code: 20999

2. Inner ear

Code: 69949

3. skin, mucous membranes and subcutaneous tissue

Code: 17999

4. Leg or ankle

Code: 27899

5. Nervous system

Code: 64999

6. Eyelids

Code: 67999


1. Paring of three warts.

Code: 11056 {lesion, skin, paring / curettement}

2. Removal of 15 skin tags

Code: 11200{lesion, skin tags, removal}

3. Shaving of 1-cm lesion of face.

Code: 11311 {lesion, skin, shaving}

Exercise 4-5 Repair {Closure} and Burns

1. The patient record states : "complex wound repair on leg, 3.1 cm"

Code: 13121 {repair, wound, complex}


Site prep, cheek, 200 cm2: 15002 for the site prep of cheek {100 sq cm},

Site prep, chest, 200 cm2: 15003-51 {100 sq cm}, and 15003{100 sq cm} for site prep chest

5. the patient had a 20-cm2 defect of the right cheek that was repaired with a rotation flap {adjacent tissue transfer}

Code: 14041 {skin, adjacent tissue transfer}


6. The patient had a 10-cm2 malignant neoplasm removed from the forehead. Z-plasty was used to repair this site. How would the excision and repair be coded?

Code: 14040 {skin, adjacent tissue transfer} {note that a Z-plasty is a form of adjacent tissue transfer. The excision is included in the adjacent tissue transfer code.}

7. A patient has had a portion of his mandible removed due to excision of a malignant tumor. Repair of the site is now performed by use of a myocutaneous flap graft.

Code: 15732 {skin, myocutaneous} {note that modifier-58 may also be used if the procedure was a staged procedure.}

1. Electrosurgical destruction of a herpetic lesion.

Code: 17110 {destruction, skin, lesion, benign} {if a specific anatomic area was indicated, you could report the destruction with a more specific code. For example, 56501 for destruction of a lesion of the vulva}

2. Cryosurgical destruction of 14 actinic keratoses.

Code: 17000{destruction, skin, benign}, 17003x13 {destruction, skin, benign}

3. Mohs' micrographic surgery by a single physician removing and examining three specimens, first stage of the neck.

Code: 17311{Mohs', first stage}

Breast Procedures

1. aspiration of one cyst, breast

Code: 19000{breast, cyst, puncture aspiration}

2. simple, complete bilateral mastectomies

Code: 19303 and 19303-50 or 19303-50 {breast, removal, simple, complete}

3. right modified radical mastectomy, including axillary lymph nodes without any muscles

Code: 19307 or 19307- RT {breast, removal, modified radical}

4. preoperative placement of one breast wire, left breast

Code: 19290- LT {breast, needle wire placement}

5. reconstruction of nipple/areola, right breast

Code: 19350-RT {breast, reconstruction, nipple, areola}


Dr Guptha, Director and Trainer for the medical coding services and ICD10 training

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