What is the primary difference between CPT and ICD codes?

CPT codes and ICD codes serve distinct and critical roles in the healthcare system, particularly in the context of medical billing and documentation. CPT, which stands for Current Procedural Terminology, is utilized primarily to describe the medical services and procedures performed by healthcare providers. This can include a wide range of activities, from consultations and evaluations to surgical procedures and diagnostic tests. The goal of CPT coding is to convey what services were provided to aid in billing and communication among providers.

On the other hand, ICD codes, which stands for International Classification of Diseases, describe diagnoses and health conditions. These codes provide standardized ways to document and report diseases, conditions, and other health-related issues. The information captured by ICD codes is essential for understanding the patient's health status, tracking public health statistics, and justifying the medical necessity of the services billed through CPT codes.

The distinction between the two is vital; CPT focuses on what has been done (procedures and services), while ICD focuses on why it has been done (the diagnoses). This clear separation helps streamline the processes of billing, insurance claims, and healthcare data analysis, ensuring accurate communication and effective data management across the healthcare system.