Diagnostic and Medical Procedure Codes: FAQ and a Little History
To new students and outsiders to the healthcare field, medical procedure codes might as well be rocket science. It’s amazing that all the things doctors do, from diagnostic tests to surgical procedures, have been compiled into a list of codes. This article is a quick and simple explanation of medical coding: what it is, its history, and its use in modern healthcare.
1. What is medical coding?
Medical coding is the behind-the-scenes work that allows hospitals, patients and insurance companies (including government-sponsored programs like Medicare) to communicate with one another.
2. What is a medical procedure code?
A medical procedure code is a set of letters and numbers that refers to a particular health intervention (procedure) performed by a healthcare professional. Examples include physical therapy treatments and all kinds of surgical procedures.
3. What is a medical diagnosis code?
A diagnosis code, unlike a procedure code, identifies a disease, symptom, injury, or any other reason a patient might visit a doctor.
4. How does medical coding work?
The healthcare industry in America uses several standardized coding systems. Instead of writing out an explanation of each diagnosis or procedure provided by a doctor for each patient, medical coders find and assign the appropriate standard codes to them. For each code, hospitals and healthcare providers charge certain fees, and insurance companies can easily access this financial information by looking up the diagnostic or medical procedure code provided to them.
5. How can medical coders remember all those codes?
Quite simply, they don’t. Though they remember many of them, medical coders don’t memorize every single code they use. Instead, they understand the systems by which each medical procedure code is sorted. Different types of procedures are sorted into categories, so the codes for heart-related procedures are in one group, the codes for skin-related (dermatological) procedures are in a different group, etc. Skilled medical coders navigate the coding systems easily, finding specific procedure codes based on broader categories.
6. What are the most common coding systems?
Two coding systems are most commonly used in the United States: the Healthcare Common Procedure Coding System (HCPCS or “hick picks”) and the International Classification of Diseases (ICD). Don’t be misled – the ICD is made up of three volumes, and one of them doesn’t classify diseases at all: it outlines medical procedure codes.
7. Who came up with this idea?
The very first version of something that resembled the ICD appeared in France in 1893. A man named Jacques Bertillion classified as many causes of death as he could into alphanumeric codes, distinguishing between general diseases and diseases that affected a particular organ. His system caught on: in the early 1900s, several other nations began to use the same codes. Today, The U.S., Canada, and several other countries use their own versions of the ICD, but a (heavily updated) version of Bertillion’s system is still used all over the world. The World Health Organization controls updates to the system, and the United Nations sponsors is. The ICD isn’t just a piece of history and a source of medical procedure codes – it’s proof that on some things, many different countries can work together.