Question

15. Explain how the ICD-10-CM code and CPT code work together to provide the necessary information about the patient’s visit to the insurance company. Include how these codes are dependent upon each other. Describe the role modifiers play when sending claims to insurance carriers for payment

Answer 1

ICD-10-CM (Clinical Modification) are codes used to describe the primary diagnosis of a patient

CPT codes are the billing codes used for getting payment from insurance companies

Step-by-step explanation:

ICD is the international standard for reporting diseases and health conditions including monitoring of disease. ICD-10 is the the 10th edition.

As explained above, ICD-10 codes describe the main/primary diagnosis this is followed by the CPT/billing code which describes how insurance companies should pay for said primary condition - making them dependent.

Modifiers are then used to give more information about the ICD-10 codes or adjust care descriptions, they provide extra details concerning a procedure or service provided by a doctor. They also help further describe a procedure code without changing its definition