Medical coding- types of codes

 

In medical coding, these terms represent different types of codes used to classify and describe healthcare services, diagnoses, and procedures:

1.     ICD (International Classification of Diseases): A diagnostic coding system used to identify diseases, conditions, and other health-related problems. For example, ICD-10 is the current version used in many countries for medical diagnosis coding.

2.     CPT (Current Procedural Terminology): Codes created by the American Medical Association to document medical, surgical, and diagnostic services. CPT codes describe what was done to the patient during the encounter.

3.     E/M (Evaluation and Management): A subset of CPT codes specifically for coding physician-patient encounters, including office visits, hospital visits, and consultations. E/M codes describe the type, complexity, and time spent on patient interactions.

4.     Modifier: Codes added to CPT or HCPCS codes to provide additional information about the service provided, such as whether a procedure was altered or only partially completed. Modifiers help provide further detail on the service performed without changing the original procedure code.

5.      HCPCS (Healthcare Common Procedure Coding System): A set of codes used primarily for billing Medicare and Medicaid services, including procedures, equipment, and supplies not covered by CPT. It consists of:

• Level I: CPT codes.
• Level II: Codes for non-physician services, medical equipment, supplies, and medications.
5. DRG (Diagnosis-Related Group): A system for categorizing hospitalization costs based on diagnoses and treatments. DRGs are used primarily for inpatient billing, allowing for standard payment amounts based on diagnosis groups, rather than specific treatments.
6. NDC (National Drug Code): Unique codes that identify pharmaceuticals, including the manufacturer, drug, and package size. NDC codes are commonly used in prescription billing to specify exact drugs and dosages dispensed.
7. SNOMED CT (Systematized Nomenclature of Medicine - Clinical Terms): A standardized coding system that provides detailed clinical terminology to represent symptoms, diagnoses, procedures, and more. SNOMED is often used in electronic health records (EHR) for detailed documentation.
8. LOINC (Logical Observation Identifiers Names and Codes): Codes used for laboratory and clinical observations, particularly in lab results and tests. LOINC ensures consistency in lab and clinical data across institutions.
9. Modifier 25 (Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service): Used when a provider performs a significant, separately identifiable E/M service on the same day as another procedure.
10. Modifier 59 (Distinct Procedural Service): Used to indicate a procedure or service that is separate and distinct from other services performed on the same day.
11. POS Codes (Place of Service Codes): Codes that indicate where the service was provided, such as in a hospital, clinic, or home setting. These codes are used on claims to provide more context for services billed.
12. MS-DRG (Medicare Severity Diagnosis-Related Group): An updated DRG system used by Medicare to assign hospital reimbursement rates based on the severity of the patient’s condition. MS-DRG classifications influence the reimbursement amount by considering patient comorbidities and complications.

More about different types of Modifers: https://www.aapc.com/resources/what-are-medical-coding-modifiers?srsltid=AfmBOor6y271UnxckxpjlM52oXMdNO5A9YbZpUmp83XauwOnc48cWvyG