Which statement differentiates ICD-10-CM from ICD-10-PCS?

• A. ICD-10-CM codes procedures; ICD-10-PCS codes diagnoses
• B. ICD-10-CM codes procedures; ICD-10-PCS codes prescriptions for outpatient settings
• C. ICD-10-CM is used for diagnoses
• D. ICD-10-CM codes diagnoses; ICD-10-PCS codes procedures for inpatient hospital settings

Answer: (D)

Think of the ICD-10 family as having two distinct roles: one codes what a patient has (diagnoses) and the other codes what was done to treat or manage the patient (procedures). ICD-10-CM is used to code diagnoses—conditions, diseases, symptoms, injuries—across most care settings. ICD-10-PCS is used to code procedures, describing the actual interventions performed, and it’s specifically designed for inpatient hospital settings.

That’s why the correct distinction is that ICD-10-CM codes diagnoses, while ICD-10-PCS codes procedures for inpatient hospital settings. Outpatient procedures are typically coded with CPT/HCPCS, not ICD-10-PCS, which is another clue why the other options don’t fit.