Medical Diagnosis/Code – Acronym Look Up

This post is taken from an email sent out by Janabeth Fleming Taylor at Attorney Medical Services:

ICD-9 codes (Think of it as "Diagnosis" Code)

The International Classification of Diseases (ICD) is the classification used to code and classify mortality data from death certificates.

The International Classification of Diseases, Clinical Modification (ICD-9-CM) is used to code and classify morbidity data from the inpatient and outpatient records, physician offices, and most National Center for Health Statistics (NCHS) surveys.

CPT Codes -Current Procedural Terminology (Think of it as "Procedure Code" upon which reimbursement is determined)

CPT Codes describe medical or psychiatric procedures performed by physicians and other health providers. The codes were developed by the Health Care Financing Administration (HCFA) to assist in the assignment of reimbursement amounts to providers by Medicare carriers. A growing number of managed care and other insurance companies, however, base their reimbursements on the values established by HCFA.

Since the early 1970s, HCFA has asked the American Medical Association (AMA) to work with physicians of every specialty to determine appropriate definitions for the codes and to try to determine accurate reimbursement amounts for each code. Two committees within AMA work on these issues: the CPT Committee, which updates the definitions of the codes, and the RUC (Relative Value Update Committee), which recommends reimbursement values to HCFA based on data collected by medical societies on the going rate of services described in the codes.

Medicare Unique Physician Identification Numbers (UPIN) – UPIN is a six-position alphanumeric identifier that is assigned to all Medicare physicians, medical groups and non-physician practitioners.

UPIN are assigned as follows:

Physicians (Medical Doctors) begin with A – M
Limited License Practitioners, e.g., Chiropractors, Dentist, etc, begin with T – V
Non-Physician Practitioners, e.g., Anesthesia Assistants, Physician Assistants, Clinical Nurse Practitioners, etc, are assigned P -S
Group Entities, e.g., Ambulance, Independent Physiological Lab, etc, are assigned W – Y
See below for the applicable Credential Codes:

AA : Anesthesia Assistant
AMB : Ambulance Service Supplier
ASC : Ambulatory Surgical Center
AU : Audiologist
CH : Chiropractor
CNA : Certified Nurse Anesthetist
CNM : Certified Nurse Midwife
CNS : Certified Clinical Nurse Specialist
CP : Clinical Psychologist
CSW : Clinical Social Worker
DDM : Doctor of Dental Medicine
DDS : Doctor of Dental Surgery
DO : Doctor of Osteopathy
DPM : Podiatrist
FNP : Family Nurse Practitioner
GRP : Group
IDF : Independent Diagnostic Facility
IPL : Independent Physiological Lab
LAB : Laboratory
MD : Medical Doctor
MSC : Mammography Screening Center
NP : Nurse Practitioner
OD : Doctor of Optometry
OT : Occupational Therapist
PA : Physician Assistant
PHS : Public Health Service
PSY : Psychologist
PT : Physical Therapist
PXS : Portable XRay Supplier
RNA : Certified Registered Nurse

Code Modifiers for Alternative Medicine – ABC codes and terminology are maintained and developed annually as consumers, individual practitioners, practitioner associations and other health industry organizations submit code requests that reflect current practices in alternative medicine, nursing and integrative healthcare. This is an attempt to fill in the "gaps" left from other coding, and is done to support research and compile data by practioner type. These include treatment by massage therapists, acupuncturists, etc. These may not be seen in traditional billing records, but may be referenced in charting or other records obtained from non-traditional medical sources: