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Code Sets

  1. Health Care Common Procedure Coding System (HCPCS)-  This code set, established and maintained by the Centers for Medicare & Medicaid Services (CMS), primarily represents items and supplies and non physician services not covered by the American Medical Association CPT-4 codes. For more information, see the link in the Related Links Inside CMS section below.  This file does not contain the CPT-4 codes. CPT-4 codes can be purchased from the American Medical Association at 1-800-621-8335.
  2. Current Procedure Terminology (CPT) codes- The CPT-4 codes are used to describe medical procedures and physicians services, and is maintained and distributed by the American Medical Association.  For more information on the CPT-4 codes, please contact the American Medical Association (AMA).   To view the website, see the link in the Related Links Outside CMS section below. 
  3. International Classification of Diseases, 9th revision, Clinical Modification ICD-9-CM Volumes 1 & 2 (diagnosis codes) are maintained by the National Center for Health Statistics, Centers for Disease Control (CDC) within the Department of Health and Human Services (HHS). To view, see the link in the Related Links Outside CMS section below.
  4. International Classification of Diseases, 9th revision, Clinical Modification ICD-9-CM Volume 3 (procedures) are maintained by CMS and are used to report procedures for inpatient hospital services. To view, see the link in the Related Links Inside CMS section below.
  5. International Classification of Diseases, 10th revision, Clinical Modification ICD-10-CM is the new diagnosis coding system that was developed as a replacement for ICD-9-CM, Volume 1 & 2. International Classification of Diseases, 10th revision, Procedure Coding System ICD-10-PCS is the new procedure coding system that was developed as a replacement for ICD-9-CM, volume 3.  The compliance date for ICD-10-CM for diagnoses and ICD-10-PCS for inpatient hospital procedures is October 1, 2015.  To view, see the link in the Related Links Inside CMS section below.
  6. National Drug Codes (NDC)- The NDC is a code set that identifies the vendor (manufacturer), product and package size of all drugs and biologics recognized by the FDA.  It is maintained and distributed by HHS, in collaboration with drug manufacturers.  To access the complete NDC code set, see the link in the Related Links Outside CMS section below.
  7. Code on Dental Procedures and Nomenclature (CDT)-  The CDT is the code set for dental services.  It is maintained and distributed by the American Dental Association (ADA).  To view the website, see the link in the Related Links Outside CMS section below. 
  8. Place of Service Codes are two-digit codes placed on health care professional claims to indicate the setting in which a service was provided. The Centers for Medicare & Medicaid Services (CMS) maintain POS codes used throughout the health care industry.  To view, see the link in the Related Links Inside CMS section below.