Medical Codes Defined

Within the field of medicine, medical codes serve as a universal tool to convey health-related data about a patient. The codes also are used by health providers and insurance companies to process submitted claims and establish the amount of money that may be reimbursed.

Significance

• The American Health Information Management Association (AHIMA) describes medical/health information coding as the conversion of verbal descriptions of diseases, injuries and procedures into numeric or alphanumeric labels.

Function

• Medical codes allow health professionals to keep track of the records in a uniform way, which is vital for the patient's care, reimbursement process, clinical research and education.

Types

• As noted on Meditec.com, the three different medical code systems used are: Healthcare Common Procedure Coding System (HCPCS), Current Procedural Terminology (CPT) and the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM).

Features

• Various agencies are in charge of overseeing the usage and implementation of medical codes, making sure they meet all federal requirements and insurance regulations.

Identification

• The Joint Commission on Accreditation of Healthcare Organizations, Institute for Safe Medication Practices and the Center for Medicare-Medicaid Services are examples of these bodies.

Considerations

• The type of medical coding system used (CPT, ICD or HCPCS) depends on who is using it and what it is being used for. For example, a medical coder would have to enter the proper HCPCS procedure code if they were submitting to Medicare or Medicaid. Moreover, each coding system contains assorted categories and sections to help ensure the precise code is used.