Current Medical Coding Classification Systems September 2015

Current Procedural Terminology (CPT) Category I also known as HCPCS I-are used to report medical procedures and services under public and private health insurance programs-there are several categories: 

Category I CPT® codes illustrate a procedure or service corresponding with a five-digit CPT® code and descriptor classification.

First published in 1966 by The American Medical Association and maintained by the CPT Editorial Board.

·    Current Procedural Terminology (CPT) Category II also known as “optional" performance measurement codes. Category II codes are used to track the performance of certain of some tests and or test results.

Category II CPT® codes are used for information purposes only, and no payment is associated with these codes.

The AMA updates these codes semiannually.

Current Procedural Terminology (CPT) Category III also known as “local” codes or “temporary” codes are used to designate emerging technologies and to track the usage of the codes. Category III codes replace HCPCS Level III codes after the HCPCS Level III codes were eliminated by HIPPA. Category III CPT® codes must be used in place of an unlisted procedure code. The reimbursement for these codes is determined by the carrier.

Developed by individual carriers and the CPT Editorial Board approved the release.

·    Healthcare Common Procedure Coding System II (HCPCS) are used to report supplies, drugs, equipment, and devices prescribed to patients, and some procedures not found in the CPT.

Level II codes were added in 2004 and are maintained by Centers for Medicare & Medicaid Services.

·         ICD-9-CM tracking diseases and mortality: 

o    Volume 1: The Tabular, a numeric listing of diseases, classified by etiology and anatomical system, Also a classification of other reasons for encounters and causes of injury. Volume 1 is used by all health care providers and facilities.

o    Volume 2: The alphabetic index used to locate the codes in Volume 1. Volume 2 is used by all healthcare providers and facilities.

o    Volume 3: An Inpatient procedural classification with a tabular section and an index. This set of procedure codes is used only by hospitals to report services. 

ICD-9-CM was first tested for use by the U.S. Public Health Service and the Veterans Administration in 1950

·    Current Dental Terminology (CDT) Dental Procedure Codes are used to report dental services to third party payers.

The American Academy of Periodontology introduced categories of dental services in 1967 and in 1969, CDT was introduced.

·    International Classification of Diseases for Oncology (ICD-O) are used in tumor or cancer registries for coding the site and histology of neoplasms.

The first edition of the International Classification of Diseases for Oncology was published in 1976.

·    National Drug Codes (NDC) - a unique 10 digit, 3 segment number used to identify and report drug products, a universal product identifier for human drugs.

In 1972 the FDA made the NDC mandatory for all prescription and over-the-counter (OTC) drugs.

·    Diagnostic and Statistical Manual of Mental Disorders (DSM)-a classification system used by mental health professionals in the United States.

DSM-I was published in 1952. The American Psychiatric Association published DSM-5 May 2013.