Question

when sending a claim to the insurance company for services provided by the physician why are both ICD-10 and CPT codes required to be submitted? What would be the result of not submitting both codes on a medical claim to the insurance company?

Answer 1

When a patient receives services from a licensed doctors, these services are recorded and assigned codes by the medical coder. ICD codes are used for diagnoses, while CPT codes are used for various treatments. The summary of these services, through these code sets, make up the bill. Medical Claim Billings are rejected when Diagnostic code (ICD-10 code) and procedure code (CPT code) are missing, not complete, or do not match to the treatment given by the physician.