Procedure Coding Systems

Current Procedural Terminology (CPT) codes are considered level 1 HCPCS codes and are maintained by the American Medical Association (AMA) whom releases new editions every October.

CPT codes are considered Level 1 HCPCS codes by the Centers for Medicare and Medicaid Services. They are designed to describe medical, surgical, and diagnostic services.

All CPT codes begin with a set of numbers and the very last value may be a number or a character (i.e. ####F, ####T)

Healthcare Common Procedure Coding System (HCPCS) codes are an additional set of procedure codes developed by the Centers for Medicare and Medicaid Services (CMS). CMS considers the first level of HCPCS codes to be CPT codes, however there are two additional levels of codes in HCPCS codes besides CPT codes.

Level 2 codes are developed by CMS and include non-physician services (i.e. ambulance services) and represent items/supplies and non-physician services not covered in CPT codes. All level 2 codes will begin with a character (i.e. A#####, B#####, C#####)

Level 3 codes include local codes developed by state Medicaid agencies, Medicare contractors and private insurers.

ICD-9-CM codes contain 3 volumes, the first two of which are diagnosis codes (see Diagnosis for information on Diagnosis ICD-9 codes) and the 3rd contains ICD-9 procedure codes.

ICD-9-CM procedure codes are used for procedures that are performed within the hospital, typically on inpatients. ICD-9 procedure codes were used until October 1, 2015, on which all U.S. health care systems were required to switch to ICD-10 procedure codes.

ICD-10-CM codes began to be used as of October 1, 2015 instead of ICD-9 codes. If the date range in your query crosses over October 1, 2015 and includes procedures, make sure to use both ICD-9 and ICD-10 codes for the procedure of interest.