Most of us come in contact with medical coding standards at some point in our lives – whether it is as physicians, medical billers, or patients. When we do, it can be helpful to know the specific purpose of each different coding system. Let’s take a look at some of the more common medical coding standards: ICD, CPT coding, LOINC, and SNOMED CT.
ICD – International Classification of Disease
The International Classification of Disease (ICD) is a widely recognized international system for recording diagnoses. It is developed, monitored, and copyrighted by the World Health Organization (WHO). Applied to any diagnosis, symptom, or cause of death, ICD consists of alphanumeric codes that follow an international standard, making sure that the diagnosis will be interpreted in the same way by every medical professional both in the U.S. and internationally.
The current version of ICD used in the U.S. is known as ICD-9, though it’s in the process of being replaced by ICD-10. Rather than simply being an updated version of ICD-9, ICD-10 is a more comprehensive and complex set of codes designed to address some of the issues of ICD-9. For example, ICD-10 codes are longer than ICD-9 codes, reducing the risk of running out of possible available codes in the future. They are also more detailed, registering finding like laterality (which side of the patient a symptom appears on), an option that has been previously absent in ICD-9.
ICD-10 is scheduled to replace ICD-9 in the U.S. starting October 1, 2015.
CPT Coding – Current Procedural Terminology
What is a CPT code? Current Procedural Terminology (CPT) coding is a U.S. standard for coding medical procedures, maintained and copyrighted by the American Medical Association (AMA). Similar to ICD coding, CPT coding is used to standardize medical communication across the board – but where ICD-9 and ICD-10 focus on the diagnosis, CPT instead identifies the services provided, and are used by insurance companies to determine how much physicians will be paid for their services.
CPT is managed by a CPT Editorial Panel, which meets three times per year to discuss current issues related to new and emerging technologies, as well as difficulties encountered with procedures and services as they relate to CPT codes. The AMA offers many products and services to provide guidance and advice, and to help you improve your understanding of CPT codes. Individuals may apply for new CPT codes or change existing CPT codes by submitting proposals to the CPT Editorial panel.
LOINC – Logical Observation Identifiers Names and Codes
Logical Observation Identifiers Names and Codes (LOINC) was created in 1994 by the Regenstrief Institute as a free, universal standard for laboratory and clinical observations, and to enable exchange of health information across different systems. Where ICD records diagnoses and CPT services, LOINC is a code system used to identify test observations. LOINC codes are often more specific than CPT, and one CPT code can have multiple LOINC codes associated with it.
Currently, more than 26,000 people in 157 countries are using LOINC, and it has been recognized as the preferred standard for coding testing and observations in HL7.
SNOMED CT – Systematized Nomenclature of Medicine
SNOMED Clinical Terms (SNOMED CT) is a comprehensive, computerized healthcare terminology –containing more than 311,000 active concepts – with the purpose of providing a common language across different providers and sites of care. As a core EHR terminology, SNOMED CT is essential for recording clinical data such as patient problem lists and family, medical and social histories in electronic health records in a consistent, reproducible manner.