DOCS MD Coding CPT, CDT, HCPCS, ICD9, ICD10, ICD11, MODIFIERS
CURRENT PROCEDURAL TERMINOLOGY
Current Procedural Terminology (CPT) is a set of codes used by healthcare professionals to uniformly document medical, surgical, and diagnostic services. These codes are developed and maintained by the American Medical Association (AMA). Each CPT code represents a specific service or procedure, which helps ensure clear communication among healthcare providers, patients, and insurers, leading to efficient and accurate billing and documentation.​​​​​​​​​​​​​​​​​​​​
ICD – 9
The International Classification of Diseases, 9th Revision (ICD-9), is a system of codes used for diagnosing and classifying diseases and health-related issues. Published by the World Health Organization (WHO), ICD-9 was widely used for medical billing and statistical purposes. Each code in ICD-9 corresponds to a specific disease or condition, aiding in accurate documentation, analysis, and comparison of health data worldwide.
ICD – 11
The International Classification of Diseases, 11th Revision (ICD-11), is the latest global standard for coding and classifying diseases, health conditions, and causes of death. Developed by the World Health Organization (WHO), ICD-11 offers more detailed and comprehensive classifications compared to previous revisions. It includes new chapters and expanded codes to cover modern medical knowledge, technological advancements, and emerging health issues.​​​​​
DX POINTERS
Diagnosis Pointers, or DX Pointers, are used in medical billing to indicate the relationship between a patient’s diagnosis and the services or procedures performed. They help specify which diagnosis corresponds to which service or procedure, ensuring accurate and timely reimbursement from insurance providers.​​​​​​​​​​​​​​​​​​​​
CURRENT DENTAL TERMINOLOGY
Current Dental Terminology (CDT) is a standardized code set for dental procedures and services. Developed by the American Dental Association (ADA), CDT codes help ensure consistent documentation and efficient communication between dental professionals, insurance providers, and patients. Each CDT code represents a specific dental procedure, which aids in accurate billing, record-keeping, and reporting within the dental field.​​​​​​
ICD – 10
The International Classification of Diseases, 10th Revision (ICD-10), is a medical coding system used globally to classify and code diseases, symptoms, and procedures. Developed by the World Health Organization (WHO), ICD-10 provides more detailed and specific classifications compared to its predecessor, ICD-9. Each code in ICD-10 represents a unique diagnosis or condition, aiding in accurate record-keeping, billing, and statistical analysis in healthcare.
MODIFIERS
In medical coding, modifiers are two-character codes added to CPT, CDT, or HCPCS codes to provide additional information about the performed service or procedure. They help specify circumstances that may affect reimbursement or documentation without changing the core meaning of the code.
DENTAL TO MEDICAL CROSS CODING
Identify the Dental Procedure: Determine the dental procedure performed, referenced by a CDT code.​
Assess Medical Necessity:
Evaluate whether the procedure has a medical necessity, which justifies converting it to a medical code.
​Find the ICD-10-CM Equivalent: Locate the ICD-10-CM code that accurately describes the patient’s condition related to the dental procedure.
​Convert to CPT Code:
Use the appropriate CPT code for the medical procedure.
​Submit the Claim: Complete the medical claim form (CMS 1500) and submit it to the medical insurance provider.​
