Operating Rules Overview - Centers for Medicare & Medicaid Services

Operating Rules Overview - Centers for Medicare & Medicaid Services

Administrative Simplification Basics Series: Code Sets

Did you know that in addition to standards and operating rules, Administrative Simplificationalso includes adopted medical code sets for use in adopted electronic transactions?

HHS adopted the following medical code sets to streamline administrative transactions that use codes for diagnoses, procedures, and more.

Health Care Activity/Item	Adopted Code Set
Diagnoses (ICD-10-CM)  Procedures (ICD-10-PCS)	ICD-10 – International Classification of Diseases, 10th edition
Outpatient services/procedures	CPT – Current Procedure Terminology
Health care equipment and supplies  Services not covered by CPT codes	Healthcare Common Procedure Coding System (HCPCS)
Dental procedures	CDT – Code on Dental Procedures and Nomenclature
Drug products	NDC – National Drug Codes