Clinical coding involves converting detailed clinical documentation into standardized codes used for billing, reporting, and data analysis.
The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) is used for classifying diseases and health conditions.
CPT stands for Current Procedural Terminology, a coding system used to describe medical procedures and services.
HCPCS Level II codes are used for coding durable medical equipment, prosthetics, orthotics, and supplies.
A CDS reviews clinical documentation to ensure that it is complete and supports accurate coding and billing.
