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Dental Basics Manual

Medical Coding - 
Differences Between Various Code Sets

CPT

  • "Current Procedure Terminology"
  • Owned and copyrighted by the AMA
  • Analogous to the ADA's CDT codes
  • Contains over 8,800 codes
  • Describe common medical procedures
  • These codes are entered in box 24D of a "1500" Health Insurance Claim Form, under CPT/HCPCS column
  • Look in this code first; if an appropriate code isn't found, then try the HCPCS

HCPCS

  • "HCFA Common Procedural Coding System"
  • Developed by the federal government (CMS)
  • Used primarily for Medicare and Medicaid to describe procedures or items not listed in the CPT manual
  • There is overlap with CPT codes
  • Level 1 HCPCS codes are in fact CPT codes
  • Level 2 HCPCS codes are unique; begin with a V or W
  • These codes are entered in box 24D of a "1500" Health Insurance Claim Form, under CPT/HCPCS column

ICD-9-CM

  • "International Classification of Diseases, 9th Edition, Clinical Modification"
  • Many dental-related codes are in Section 520 - 529 (Diseases of Oral Cavity, Salivary Glands, and Jaws)
  • These codes are entered in box 21 of a "1500" Health Insurance Claim Form, under Diagnosis of Illness

More free Dental Practice Management Free goodies:

Dr. O's Dental Consultant Management Downloads 

Dr. O's Dental Office Sample Letters

Dr. O's Dental Insurance and Coding Documents

 
Written by Jacob Hodara

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