What are the codes used for billing professional services in healthcare called?

The codes used for billing professional services in healthcare are referred to as Current Procedural Terminology (CPT) codes. These codes are published and maintained by the American Medical Association (AMA) and are used to describe medical, surgical, and diagnostic services. This standardization allows healthcare providers to report services consistently while ensuring proper reimbursement from insurance companies and government payers.

CPT codes are essential for billing because they provide a universal language that healthcare providers can use to communicate what procedures were performed. This enables accurate coding, facilitates proper billing, and helps in tracking healthcare services.

In contrast, other coding systems serve different purposes. International Classification of Diseases (ICD) codes are primarily used to classify and code diagnoses and health conditions. Healthcare Common Procedure Coding System (HCPCS) codes include additional procedures, supplies, and services not covered by CPT codes but are not specifically for professional services. Diagnosis Related Group (DRG) codes are used for hospital billing to categorize inpatient stays and determine reimbursement based on the diagnosis and treatment provided.