Health Care Code Sets: ICD-10 (MLN Matters)

Mary Madison, RN, RAC-CT, CDP 
Clinical Consultant – Briggs Healthcare

MLN Matters has posted a Health Care Code Sets Fact Sheet which is a great educational and reference tool.  You’ll find updated information in red font within the Fact Sheet.

Medicare code sets provide an easy guide for health care providers, suppliers, medical coders, and billing and claims staff when submitting inpatient and outpatient claims for diagnoses, procedures, medical equipment, supplies, and drugs.

HHS requires everyone covered by the Health Insurance Portability and Accountability Act (HIPAA) report ICD-10 codes for diagnoses and inpatient hospital procedures. HIPAA requires providers and health plans use standard content, formats, and coding for health care transactions. Find code sets in the Resources section.

ICD-10-CM diagnosis codes provide the reason for seeking health care; ICD-10-PCS procedure codes tell what inpatient treatment and services the patient got; CPT (HCPCS Level I) codes describe outpatient services and procedures; and providers generally use HCPCS (Level II) codes for equipment, drugs, and supplies for services and treatment.

It’s 6 pages in length and provides these Resources:

Share this Fact Sheet with your team.