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RCM glossary

ICD-10-CM

The diagnosis code set used in the US to report why a patient was treated.

ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) codes describe diagnoses, symptoms and reasons for encounters. Every claim line links to one or more diagnosis codes that justify the service.

The code set is updated every October 1, so codes valid last year may be invalid now.

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Related terms

CPT code
The five-character code set used to report medical procedures and services.
Medical necessity
The requirement that a service is reasonable and needed for the patient's condition.
HCPCS Level II
Codes for supplies, equipment, drugs and services not covered by CPT.

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