Table of ContentsView AllTable of ContentsHow to LocateWhy You May Need ItWhat the Codes MeanHow They Are Used
Table of ContentsView All
View All
Table of Contents
How to Locate
Why You May Need It
What the Codes Mean
How They Are Used
Looking up ICD-10 codes can help you understand your medical bills. You may need to look up an ICD-10 code if you’re trying to sort out amedical pre-approvalor billing issue with your health insurance provider.
SDI Productions / Getty Images
There are more than 70,000 ICD-10 codes, each with specific definitions.This can make it challenging to look them up and find the right code. If the code is incorrect, the coverage or approval of a test or treatment may be denied.
ICD-10 Code Lookup
Look for the specific ICD-10 code on your medical records. If you can’t find it, there are several other places you can search, including governmental online search engines and commercial apps.
Medical Records
You can often find the ICD-10 code printed after or under the “Diagnosis” (or “Dx”) heading on a medical report, bill, or provider letter.Explanation of benefits (EOB)statements from your insurer might also contain ICD codes. It can contain up to seven characters, starting with a capital letter.
Unfortunately, not every provider includes ICD-10 codes on a medical report. If this is the case, you may need to look it up yourself.
NCHS ICD-1O Code Browser
You can then click on the ICD-10 category on the results page (like “dermatitis and eczema”) to find the exact ICD-10 code for the condition you experienced (such as “allergic contact dermatitisdue to metals”).
CMS ICD-10 Code Lookup Tool
After you click on the link, you can scroll down the document to the “ICM-10-CM Codes That Support Medical Necessity” heading to find the relevant ICD-10 code for your condition.
You can also check if the test is notcovered under “ICM-10-CM Codes That Do Not Support Medical Necessity.” This may help you understand why a claim was denied.
ICD10Data.com
ICD10Data.comis a free commercial website that allows you to click on a list of 22 medical categories (like “diseases of the skin”) and continue clicking from subcategory (like “dermatitis and eczema”) to sub-subcategory (like “allergic contact dermatitis”) and sub-sub-subcategory (like “allergic contact dermatitis due to metals”) until you get the exact ICD-10 code you need.
Are You Using the Right Revision?The ICD receives annual updates, which can sometimes affect coding. In 2023, for example, 34 new codes were added.This is why you need to be sure that the code included in a medical report is from the current revision. If not, you may experience problems with billing or claims.
Are You Using the Right Revision?
The ICD receives annual updates, which can sometimes affect coding. In 2023, for example, 34 new codes were added.This is why you need to be sure that the code included in a medical report is from the current revision. If not, you may experience problems with billing or claims.
The ICD receives annual updates, which can sometimes affect coding. In 2023, for example, 34 new codes were added.
This is why you need to be sure that the code included in a medical report is from the current revision. If not, you may experience problems with billing or claims.
Why You May Need to Look Up a Code
You may need to look up an ICD code because:
In some cases, the claim will have been denied simply because the code was incorrect. At other times, a dispute may arise when the ICD-10 code (which classifies diagnosis) does not align with the CPT code (which classifies procedures) or HCPSC code (which classifies drugs, supplies, and other procedures not included in the CPT).
If this happens, finding the ICD-10 code can help you determine where the problem arose and what you can do to fix it.
What Codes Mean
ICD-10 codes consist of up to seven characters that classify medical diagnoses in a specific way:
Each ICD-10 code starts with a capital letter from A to Z. The letters broadly categorize the nature of the diagnosis as follows:
Thereafter, additional numbers and letters help specify and characterize the condition. For example, E10.9 stands fortype 1 diabetesand E11.9 istype 2 diabetes.
How ICD Codes Are Used
ICD codes are used in billing, treatments, and statistics collection. Having the right code is important to ensure that standardized treatment for a medical issue is delivered and that medical expenses are reimbursed.
Insurance Reimbursement
In other words, if the service isn’t one that would typically be provided for someone with that diagnosis, an insurance company will not pay.
For example, your healthcare provider should not submit a bill for an X-ray if you come in complaining of a rash since imaging is not indicated for that concern.
Disease Management
An ICD code is assigned to every disease. If you have a chronic illness, such as diabetes or heart disease, your ICD code will typically follow your medical records.
In a hospital setting, this can be lifesaving. But for patients with chronic conditions who come to the hospital for an unrelated issue, this can cause frustration.
When you meet a new healthcare provider, they may ask questions about the chronic illness first instead of focusing on your reason for being in the hospital. However, while a condition may seem unrelated to you, there may be a connection known only to the physician.
This process makes sense when you consider that about 80% of “older adults” have at least one chronic health condition while 50% have two or more.
Still, this reality sometimes results in a provider ordering unnecessary tests and treatments that are indicated for the chronic condition rather than focusing on the concern that caused you to seek treatment.
Other Uses
ICD codes are used globally to track health statistics and causes of death. This is helpful for gathering data on chronic illnesses as well as new ones. For example, a new code was added to the ICD-10 in 2020 to trackvaping-related illnesses.
ICD codes are also used in clinical trials to recruit and track subjects and are sometimes, though not always, included on death certificates.
Summary
The International Classification of Diseases (ICD) is a tool that assigns codes for diseases, symptoms, abnormal findings, and external causes of a disease or injury. Insurance companies expect the codes, called ICD-10 codes, to be consistent between a condition and the treatment delivered.
If they are not, a claim or authorization may be denied. Learning how to look up an ICD-10 code can help you overcome errors that might otherwise affect you financially or medically.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM).CMS.gov.2023 ICD-10-PCS.Centers for Medicare & Medicaid Services.ICD-10 implementation guide for payers.Centers for Disease Control and Prevention.Depression is not a normal part of growing older.Centers for Disease Control and Prevention.New ICD-10-CM code for vaping-related disorder to be implemented April 1, 2020.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM).CMS.gov.2023 ICD-10-PCS.Centers for Medicare & Medicaid Services.ICD-10 implementation guide for payers.Centers for Disease Control and Prevention.Depression is not a normal part of growing older.Centers for Disease Control and Prevention.New ICD-10-CM code for vaping-related disorder to be implemented April 1, 2020.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM).CMS.gov.2023 ICD-10-PCS.Centers for Medicare & Medicaid Services.ICD-10 implementation guide for payers.Centers for Disease Control and Prevention.Depression is not a normal part of growing older.Centers for Disease Control and Prevention.New ICD-10-CM code for vaping-related disorder to be implemented April 1, 2020.
Centers for Disease Control and Prevention.International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM).
CMS.gov.2023 ICD-10-PCS.
Centers for Medicare & Medicaid Services.ICD-10 implementation guide for payers.
Centers for Disease Control and Prevention.Depression is not a normal part of growing older.
Centers for Disease Control and Prevention.New ICD-10-CM code for vaping-related disorder to be implemented April 1, 2020.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
