ICD-9-CM versus CPT-4

Do you know what the header of this article means?  If you do, you more than likely have some experience in the medical billing and coding profession.  The next question would be; do you know the answer to this question?  What are these things? Are they important and how are they different?  Are they for facility coding/billing or are they for physician based coding/billing.  What are your thoughts?

If you have spent any time in this profession, you should know the difference in these items and how they affect your working environment.  When do you use ICD-9-CM and when do you use CPT-4? Can you explain the process?

Here is the insight to the above questions:  ICD-9-CM stands for the International Classification of Diseases, 9th Revision, Clinical Modifications and the CPT-4 is the Current Procedural Terminology, 4th edition. ICD-9-CM is used for facility coding and CPT is used for physician based coding.  What is so interesting is that ICD-9 is diagnoses and procedures where CPT-4 is only procedures and services.  Many people question why we need to still learn ICD-9-CM when ICD-10 is getting ready to be implemented?  Well, here is the reason why…even if ICD-10 were to be put into effect next October1, 2013 every biller and coder will still be working with ICD-9-CM for one calendar year following the implementation date.  So, ICD-9-CM may seem obsolete but this resource is not going away quickly and it may be around longer than some would hope.  If it has been determined that the profession is not prepared for the implementation of ICD-10, the profession will wait until ICD-11 will be released as it is being worked on at this time.

So if you ever find yourself questioning why you need to learn the ICD-9-CM, there is a good reason for this and you should embrace this process. Just imagine that eventually CPT-5 will be on the horizon and we will be answering these questions all over again only this time for CPT rather than ICD.  If you are looking to grow your prospects in this profession, there really is no better time than the present to take the reins and learn the process.  What are you waiting for?  Your future is waiting…….