Certified Revenue Cycle Representative (CRCR) Practice Exam

What are the primary coding systems currently used in healthcare?

1. ICD-9 and HCPCS

2. ICD-10-CM/ICD-10-PCS and CPT/HCPCS codes

3. SNOMED and LOINC

4. DRG and APC codes

The correct answer is: ICD-10-CM/ICD-10-PCS and CPT/HCPCS codes

The primary coding systems currently used in healthcare primarily include ICD-10-CM/ICD-10-PCS and CPT/HCPCS codes. ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) is used for coding diagnoses and inpatient encounters, while ICD-10-PCS (Procedure Coding System) is used specifically for coding procedures performed during hospital inpatient stays. These coding systems provide a standardized way to document and categorize health conditions and procedures, facilitating data analysis, billing, and health management. CPT (Current Procedural Terminology) and HCPCS (Healthcare Common Procedure Coding System) codes complement the ICD coding systems by detailing medical procedures and services provided to patients in various healthcare settings. CPT codes are used primarily in outpatient settings to report medical services and procedures, while HCPCS includes services and items not covered by CPT codes, such as certain durable medical equipment. Together, these coding systems support accurate billing, statistical reporting, and enhanced patient care through standardized documentation, which is essential for reimbursement processes and healthcare tracking.