What is the difference between ICD-10-CM and ICD-10-PCS?

ICD-10-CM and ICD-10-PCS are both parts of the International Classification of Diseases, 10th Revision, but they serve different purposes in medical coding.

ICD-10-CM stands for International Classification of Diseases, 10th Revision, Clinical Modification. It is used primarily for diagnosing diseases and conditions. Healthcare providers use ICD-10-CM codes to record and track patient diagnoses, which helps in various aspects like billing, insurance claims, and tracking disease patterns.

On the other hand, ICD-10-PCS stands for International Classification of Diseases, 10th Revision, Procedure Coding System. It is specifically designed for coding procedures performed in hospital settings, particularly inpatient procedures. While ICD-10-CM focuses on the “what” of a patient’s health issue, ICD-10-PCS focuses on the “how” of the treatments and surgeries that are performed to address those health issues.

In summary, the main difference lies in their use: ICD-10-CM is used for diagnosing diseases and conditions, while ICD-10-PCS is used for coding the procedures and treatments performed in hospitals. Both systems are essential for accurate medical documentation, billing, and data analysis in healthcare.

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