Medical Coding Books

These coding books are used to translate a written medical record into number sets prior to insurance submission.

Number sets, also called medical codes, each represent a unique descriptor found in one of the three books.

CPT, ICD-9-CM, & HCPCS

• Current Procedural Terminology (CPT)
• International Classification of Diseases, 9th edition, Clinical Modification (ICD-9-CM)
• Healthcare Common Procedural Classification System (HCPCS)

Codes can be selected from one, two, or all three medical coding books when coding a single medical record. Each book is distinct from the other, carrying it's own set of unique codes, descriptors, and guidelines.

The Current Procedural Terminology book contains medical codes that are often called CPT codes or National Level I codes.

These CPT codes depict procedures and services that can be performed by physicians, surgeons, specialists, and ancillary staff.

In professional coding CPT codes are what insurance companies base their reimbursement on.

All CPT medical codes are completely numeric and they are always five digits in length. Each five digit number set is unique and is not repeated in any other medical coding book. Each medical code also has a unique detailed descriptor attached to it.

~ Codes for surgical procedures performed on the following organ systems: Integumentary, Musculoskeletal, Respiratory, Cardiovascular, Hemic and Lymphatic, Mediastinum, Digestive, Urinary, Male and Female Genitalia (includes maternity procedures), Nervous, Ocular, and Auditory.

• CPT Book Layout:

~ E/M codes are listed next, followed by Anesthesia, Surgery (by organ system), Pathology, Radiology, and Medicine codes.

~ Category II and III codes are listed next. These unique codes are use for quality control measures and new technology.

~ Appendicies A - M are located near the end.

~ The alphabetic Index makes up the final portion of the CPT book and is used to look up codes by procedure name or anatomical locaiton.

This medical coding book was first published in 1948 and is updated every year with changes effective October 1st of each year.

The ICD-9-CM (also known as the ICD-9) is divided into three volumes. Volume I is known as the Tabular Index, Volume II is known as the Alphabetic Index, and Volume III is known as either the Operative Index or the Procedure Index.

Volumes I and II are used in both the professional and facility settings and Volume III is reserved for facility settings only.

Volumes I and II contain medical codes that depict a diagnosis. These "diagnosis" codes are used to describe accidents, illnesses, injuries, and conditions.

Codes from this medical coding book are three to five digits in length, have a decimal point following any third digit, and can be numeric or alpha-numeric in nature.

Volume III contains medical codes for procedures performed in a facility setting. These medical codes are numeric, three to four digits in length, and have a decimal point following any second digit. Volume III also has a separate alphabetic index for locating its codes.

• ICD-9-CM Codes Include:

~ 3-4 digit numeric codes that describe in patient procedures (vol. III)

~ V codes; 3-5 digit codes that begin with a V and decribe circumstances for healthcare encounters.

~ "E" Codes; 3-5 digit codes that begin with an E and describe how an accident or injury occured.

• ICD-9-CM Book Layout:

~ Volume II (Alphabetic Index) is located next. This lists all accidents, injuries, diseases, and conditions alphabetical by name and includes three tables; Table of Hypertension, Table of Neoplasms, & Table of Chemicals and Drugs.

~ External cause index (E code index) is used specifically to reference E codes. This index is located between Volumes I and II.

~ Volume I (Tabular Index) makes up the center portion of the book. This contains all codes with their full descriptions, conventions, and notaitons.

~ Appendicies A-E

~ Alphabetic index for Volume III. This lists all in patient procedures in Volume III alphabetically for reference.

~ Tabular index for Volume III. This index contains all Volume III codes with their full descriptions, conventions, and notations.

~ References

HCPCS codes are also know as National Level II codes. These codes are used to depict non-physician services, Durable Medical Equipment (DME), supplies, and drugs that are not covered by CPT national level I codes.

HCPCS codes are five digits in length with no decimal holders and are alphanumeric in nature. Each codes begins with a letter and is followed by four numbers. The HCPCS book structured very similar to the CPT book.

• HCPCS Codes Include:

• HCPCS Layout:

~ The Table of Drugs with drugs listed alphabeticaly is next.

~ HCPCS modifiers listed with their full description is located between the Table of Drugs and the Tabula index.

~ The Tabular index lists all codes with their full description, conventions, and notations and is located in the center of the book.

~ Appendix A which is for Internet Only Manuals makes up the remainder of the book.