How do ICD-10-CM and CPT coding differ?

How do ICD-10-CM and CPT coding differ?

• A. CPT codes diagnose conditions; ICD-10-CM codes describe procedures and services performed.
• B. They are interchangeable and describe both diagnoses and procedures.
• C. ICD-10-CM codes diagnose conditions; CPT codes describe procedures and services performed.
• D. ICD-10-CM describes services; CPT codes diagnose conditions.

Answer: (C)

The main idea is that ICD-10-CM codes identify diagnoses and reasons for encounters, while CPT codes describe the procedures and services performed. ICD-10-CM explains why the patient was seen—the condition or symptom—whereas CPT captures what was done during the visit or procedure, such as the office visit, tests, imaging, or treatments. On a typical claim, you’ll see ICD-10-CM codes for the diagnosed condition and CPT codes for the actual services provided, all tied together to justify medical necessity. For example, a patient diagnosed with bronchitis would have an ICD-10-CM code for bronchitis, and the claim would include CPT codes for the office visit and any procedures or tests performed. This separation is what allows both the diagnosis and the care delivered to be described accurately; CPT codes do not diagnose conditions, and ICD-10-CM codes do not describe procedures.

The main idea is that ICD-10-CM codes identify diagnoses and reasons for encounters, while CPT codes describe the procedures and services performed. ICD-10-CM explains why the patient was seen—the condition or symptom—whereas CPT captures what was done during the visit or procedure, such as the office visit, tests, imaging, or treatments. On a typical claim, you’ll see ICD-10-CM codes for the diagnosed condition and CPT codes for the actual services provided, all tied together to justify medical necessity. For example, a patient diagnosed with bronchitis would have an ICD-10-CM code for bronchitis, and the claim would include CPT codes for the office visit and any procedures or tests performed. This separation is what allows both the diagnosis and the care delivered to be described accurately; CPT codes do not diagnose conditions, and ICD-10-CM codes do not describe procedures.