In either example the diagnosis would be 790.93, elevation of PSA. However, a PSA level of 0.5 several months after a radical prostatectomy would represent an elevation. For example, an elevation of PSA above four may or may not represent a true elevation. A PSA level is considered elevated when determined as elevated by the attending urologist not only by the determined level itself. ICD-9 code 790.93 and ICD-10 code R07.2 indicate an elevated prostate-specific antigen (PSA). Other diagnoses often associated with neoplasms of the prostate include carcinoma in situ of the prostate, high grade prostatic intraepithelial neoplasm, high grade PIN, diagnostic codes 233.4 for ICD-9 and D07.5 for ICD-10, dysplasia of the prostate, PIN grades 1 and 2, diagnostic codes 602.3 for ICD-9 and N42.3 for ICD-10 ( Table 63.1). Codes 185 and C61 include the various histological malignant tumors of the prostate namely, the common adenocarcinoma, transitional cell tumors, squamous cell tumors, and prostatic sarcoma. Most ICD-9 codes are numeric and all ICD-10 codes are alpha-numeric. 185 is all numeric and C61 is alpha-numeric. Note that ICD-9 code 185 and ICD-10 code C61 contain three characters. Medical billers and health insurance companies should have both books.ġ.Current Procedural Terminology (CPT) is a medical code manual published by the American Medical Association while the International Classification of Diseases (ICD) is a medical code manual published by the World Health Organization.Ģ.The CPT code describes what was done to the patient during the consultation, including diagnostic, laboratory, radiology, and surgical procedures while the ICD code identifies a diagnosis and describes a disease or medical condition.ģ.CPT codes are more complex than ICD codes.Ĥ.The CPT book is updated every three to five years while the ICD book is updated every 10 to 15 years.ICD-9 code 185 and ICD-10 code C61 are the diagnostic codes used for malignant neoplasm of the prostate. ICD books have to be updated every 10 to 15 years while CPT books every 3 to 5 years. While for a certain ailment a diagnosis may only have one code, to determine the code in the CPT coding would involve determining the circumstances of the patient’s visit to the physician, the time the doctor spent with the patient, how many body systems he examined among other concerns. This system is not found in the ICD book.ĬPT codes are more complex than ICD codes. The CPT book has a health care common procedure coding system and focuses on medications and equipment for which a patient is billed. The ICD book is published by the World Health Organization and has 24,000 codes for its ICD-9 and more than 200,000 codes for its ICD-10. The CPT book is published by the American Medical Association and has 7,800 codes. It describes the medical condition or disease that is being treated so that all parties involved the doctor, patient, and insurer will understand better the disease which is being treated. After diagnosing what is wrong with a patient, a physician will assign a diagnosis code which can be found in the ICD-9 or ICD-10 book. The ICD book has codes that identify a diagnosis and describe a disease or medical condition. It aims at providing a uniform language to describe the treatment and diagnostic procedures performed and aid in the communication between doctors, patients, and insurance companies. It describes the medical services and procedures done by the physician. It describes what was done to the patient during the consultation and the procedure code can be found in the CPT book. The CPT book has codes for reporting medical procedures and services such as diagnostic, laboratory, radiology, and surgical. ![]() ![]() There are two manual codes used by medical billers and insurers: the Current Procedural Terminology (CPT) and International Classification of Diseases (ICD). To hasten the payment process and to make everyone understand the medical problem, manual codes are provided. Not only are the patients and the doctors involved in the treatment and the diagnosis of a medical problem but also the medical insurers. With health insurance, they get a cheaper and more convenient way to get their ailments treated. That’s why most people have acquired medical or health insurance for themselves and their families.
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