Nursing Informatics

NIs Must be knowledge about: CPT, ICD

Current Procedural Terminology (CPT)

  • was developed by the American Medical Association (AMA)
  • is used to code for medical procedures and services under health insurance plans (both pubic and private)
  • used for billing and reimbursement of outpatient procedures and interventions in health care except for alternative medicine
  • the code set is copyrighted by the AMD and is continually evaluated and updated annually in October of each year.

Medicare utilizes an adjusted form of CPT, the HCPS code. While International Classification of Disease (ICD-9/ ICD-10) codes are used to code for procedures, ICD coding is used only for inpatients.

International Classification of Disease (ICD-9/ ICD-10) codes

  • developed by the World Health Organization (WHO)

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