CPT vs ICD: Difference and Comparison

We must undergo a rigorous and confusing medical procedures whenever we go to a hospital. At that time, medical practitioners used some codes which a doctor and medical insurers recognized.

These are some standardized codes for every function related to medical procedures. CPT and ICD are two types of medical codes used in this process.

Key Takeaways

1. CPT codes are used to describe medical procedures and services, while ICD codes are used to describe diagnoses and medical conditions.
2. CPT codes are used primarily by healthcare providers and medical coders to bill insurance companies, while healthcare providers use ICD codes to document patient diagnoses and medical conditions.
3. CPT codes are updated annually, while ICD codes are updated every few years and are used internationally.

CPT vs ICD

The difference between CPT and ICD is that CPT stands for Current Procedural Terminology, and it is used to describe all the medical procedures and services provided during medical consultation. On the other hand, ICD is the International Classification of Disease and describes diseases using various codes.

CPT is the short form of Current Procedural Terminology, and it has thousands of codes denoting all the procedures and services performed by physicians.

These services can be a simple diagnosis or a complex surgery. It has one code for each. It is published by American Medical Association, known as AMA.

ICD is the short form of the International Classification of Disease, and it has codes denoting disease and diagnosis related to that particular disease.

Once the medical practitioner finds out about the disease, it assigns a diagnosis code that can be found in the ICD code book. It is published by the World Health Organization, commonly known as WHO.

Comparison Table

Parameters of Comparison	CPT	ICD
Full Form	Current Procedural Terminology	International Classification of Disease
Publisher	It is published by American Medical Association (AMA).	It is published by the World Health Organization (WHO).
Update Frequency	It is updated every three to five years.	It is updated every 10 to 15 years.
Use	CPT code is used to describe what is done to a patient.	ICD is used to identify the diagnosis and determine the disease.
Number of Codes	It has approx 10,000 codes, which keep updating for 3 to 5 years.	It has lakhs of codes, updating every 10 to 15 years.

What is CPT?

CPT is Current Procedural Terminology founded American Medical Association in 1966. It is a set of manual codes used by medical coders and billers to denote the various medical procedures.

Codes in this book describe the service given by doctors during consultation.

This book of codes is divided into three categories: category I, category II, and Category III. Category I is further divided into six sub-categories. It has a code made up of 5-digit numeric codes.

These categories include code for anaesthesia, surgery, radiology, pathology and laboratory, medicine, and evaluation and management.

Category II codes combine 4 numeric digits and one alphabet at the end. It consists of 11 codes. This category of codes is used for clinical components used for medical services and evaluation and management of medical procedures.

The Performance Measures Advisory Group (PMAG), an advisory body of its editorial panel, assesses these codes.

Category III of CPT codes are used to describe emerging technologies. These codes are copyrighted material of the American Medical Association, but still, it is mandatory for almost all health insurance payment and information systems.

The users of this code have to pay the license fee to access these codes.

What is ICD?

International Classification of Disease is a book of codes to determine the disease and diagnosis of the same. The codes describe the particular disease and its diagnosis, which help insurers, patients, and doctors to understand the medical condition.

These codes are understandable and accepted internationally.

It was developed by the World Health Organization (WHO), and WHO is also responsible for monitoring and maintaining these books of codes as it owns the copyright of these books of codes.

It has many versions. Currently, ICD-9 and ICD-10 are followed. ICD-9 contains 24,000 codes, and ICD-10 has 200,000 codes in it.

These codes are alphanumeric codes describing any disease, diagnosis, and cause of death. The ICD-9 version of these codes are used in the United States, and they are replacing it with another version of ICD-10.

It is more complex and longer than the previous version. Similarly, the version of these codes gets regular updates that keep replacing the previous one.

WHO keeps making minor changes in this book of codes every year and releases a major update in 10 to 15 years. It has planned to launch the eleventh version of ICD-11 in 2022.

This version of ICD was already accepted in 2019 by WHO.

Main Differences Between CPT and ICD

1. CPT is owned and maintained by American Medical Association, while ICD is monitored, maintained, and published by the World Health Organization.
2. CPT has three categories and is updated every three to five years. On the other hand, ICD currently has 10 versions that keep updated every ten to fifteen years.
3. CPT codes describe medical procedures and services provided, whereas ICD codes describe the disease and its diagnosis.
4. CPT has approx 10,000 codes in total, but ICD-10 alone has 200,000.
5. CPT is more complex as one disease includes different codes for different procedures for the same disease. In contrast, ICD is simple as it has only one code for one disease and its diagnosis.

References

1. https://www.liebertpub.com/doi/abs/10.1089/wound.2013.0483
2. https://n.neurology.org/content/79/10/1049.short