Manual Comparisons Flashcards
What is the primary purpose of ICD-10-CM codes?
Diagnostic coding – ICD-10-CM is used to classify and code diagnoses, symptoms, and conditions.
What is the primary purpose of CPT codes?
Procedure coding – CPT codes describe medical, surgical, and diagnostic procedures and services.
What is the primary purpose of HCPCS codes?
Coding for supplies, equipment, and non-physician services – HCPCS (Level II) supplements CPT and includes things like ambulance rides, durable medical equipment, and some drugs.
What is the format of an ICD-10-CM code?
One letter followed by 2-7 alphanumeric characters, with a decimal after the third character (e.g., M54.5).
What is the format of a CPT code?
5-digit numeric code (e.g., 99213).
What is the format of a HCPCS Level II code?
One letter followed by four digits (e.g., A0428 for ambulance service).
Are CPT codes part of the HCPCS system?
✅ True – CPT codes are considered HCPCS Level I codes.
Who maintains ICD-10-CM codes?
The National Center for Health Statistics (NCHS) and CMS (Centers for Medicare & Medicaid Services).
Who maintains CPT codes?
The American Medical Association (AMA).
Who maintains HCPCS Level II codes?
The Centers for Medicare & Medicaid Services (CMS).
Which code set is used to describe procedures for outpatient care?
CPT – It’s used primarily for outpatient and physician services.
Which code set is used to report diagnoses in all care settings?
ICD-10-CM – It’s used for both inpatient and outpatient diagnoses.
Which code set would include codes for a wheelchair or surgical supplies?
HCPCS Level II – It covers medical equipment and supplies.
Can ICD-10-CM codes be used to justify the medical necessity of CPT or HCPCS services?
✅ True – ICD-10-CM codes explain why a service was provided.
Which coding system is used most frequently in physician billing?
CPT – It directly relates to procedures and services performed by healthcare providers.
