Common Codes Used In Medical Coding - CPT, HCPCS And More

When you walk out of a clinic after an appointment or you get discharged from a hospital where you were a patient, you will be handed a piece of paper with a set of numbers on them. If you are wondering what those numbers indicate, they are codes that describe your diagnosis and treatment. These are called CPT codes, used to describe your illness and your treatment, and are also sent to your medical insurance company for reimbursement.

CPT stands for Current Procedural Terminology which is used to describe every task or service performed by your medical practitioner. These include diagnostics, medical and surgical procedures. CPT codes were developed by the American Medical Association (AMA) and are regularly updated and maintained by them. Old codes no longer in use are discarded and new codes are added. These codes are used to maintain a patient's history and also for billing the patient's medical insurer. You must remember that all medical insurers do not pay the same amount for a medical procedure. For example, Company A may reimburse a doctor $100 for a medical checkup while Company B may pay $80 for the same checkup. Further, Medicare uses their own set of codes known as HCPCS, which are very similar to CPT codes.

There are thousands of CPT codes in use and these are updated periodically by the American Medical Association. If a patient wants to know what was their diagnosis and procedure performed on them they can visit the AMA website and lookup the codes. Since the AMA spends an enormous amount of money to update and maintain the CPT codes they hold the copyrights to it. No individual can download or use the codes without their authorization; for which they charge a fee. However people can look up individual codes to find out what medical services were provided to them. They can also track their medical history by cross checking previous bills with the CPT codes. Medical insurance companies have to pay AMA to get access to this rather large database.

HCPCS are codes used by Medicare and Medicaid and they are updated and maintained by them. The level I HCPCS codes are similar to the CPT codes. However there is a level II of HCPCS codes which are used by medical suppliers for providing services like ambulance services and medical equipment. As medical suppliers are not necessarily associated with a doctor's office Medicare and Medicaid deal with these bills separately as the doctor does not include them in his bill.