CPT Lookup vs. ICD-10 Lookup: What’s the Difference and When to Use Each?

CPT Lookup vs. ICD-10 Lookup: What’s the Difference and When to Use Each?

In the world of medical billing and coding, accuracy is everything. One of the most common questions new Medical Biller and even providers ask is:

“What’s the difference between CPT and ICD-10 lookups, and when do I use each?”

Both CPT and ICD-10 codes are essential to insurance claims—but they serve completely different purposes. Using the wrong one (or mixing them up) can lead to claim denials, delayed payments, or compliance issues.

This article explains:

• What CPT and ICD-10 codes are

• How CPT and ICD-10 lookup tools differ

• When to use each

• Tools to help you code more efficiently and correctly

What Are CPT Codes?

CPT (Current Procedural Terminology) codes are developed by the American Medical Association (AMA). These five-digit numeric codes describe the medical procedures, services, and tests performed by healthcare providers.

CPT Codes Are Used For:

• Office visits (e.g., 99213)

• Diagnostic tests (e.g., 93000 for ECG)

• Surgeries (e.g., 27447 for total knee replacement)

• Preventive care

• Telehealth services

• Therapy sessions

Think of CPT codes as the "what was done" in the patient encounter.

What Are ICD-10 Codes?

ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) codes are maintained by the World Health Organization (WHO) and CDC/NCHS in the U.S. These alphanumeric codes describe a patient’s diagnosis, symptoms, and health conditions.

ICD-10 Codes Are Used For:

• Diagnosing diseases (e.g., J45.909 for asthma)

• Describing symptoms (e.g., R07.9 for chest pain)

• Identifying chronic conditions (e.g., E11.9 for type 2 diabetes)

• Reporting comorbidities and complications

• Supporting medical necessity for procedures

ICD-10 codes explain "why the service was provided."

Key Differences Between CPT and ICD-10

When to Use CPT Lookup vs. ICD-10 Lookup

✅ Use a CPT Lookup Tool When You Need To:

• Bill for services performed during a visit

• Find a procedure or treatment code

• Check reimbursement rates or modifiers

• Determine if prior authorization is needed

• Verify global periods for surgical billing

✅ Use an ICD-10 Lookup Tool When You Need To:

• Identify the diagnosis or reason for the visit

• Match diagnoses to procedures for medical necessity

• Document chronic, acute, or symptom-based conditions

• Code comorbidities for risk-adjusted payments

• Meet compliance standards for payer reporting

Both are needed for almost every insurance claim.

Why the Right Tool Matters

Using accurate CPT and ICD-10 codes is crucial—but so is using the right lookup tool. Manually searching PDFs or outdated codebooks slows you down and increases risk of errors.

Recommended CPT Lookup Tools:

• AMA CPT Assistant – Official source, very detailed

• Find-A-Code – Combines CPT, ICD, and HCPCS lookups

• AAPC Codify – CPT/ICD crosswalks and guidelines

• CMS Fee Schedule – For CPT rates and Medicare rules

• EncoderPro – Enterprise-level CPT tool for hospitals

Recommended ICD-10 Lookup Tools:

• ICD10Data.com – Free, fast, beginner-friendly

• CDC ICD-10 Lookup Tool – Government source

• AAPC Codify – Great for coding accuracy and training

• Find-A-Code – Excellent cross-referencing

• NaviCure or TruCode – For enterprise integration

Some tools combine both, which is ideal for speed and accuracy.

CPT and ICD-10 in a Real Billing Scenario

Example: A patient comes in with chest pain.

• The ICD-10 code for the diagnosis might be R07.9 (chest pain, unspecified).

• The CPT code for the EKG performed could be 93000.

• The biller uses both codes in the claim: one to explain why the service was necessary (ICD-10), and one to show what was done (CPT).

The claim won't get paid unless both codes are accurate and linked correctly.

Top 5 CPT Code Lookup Tools for Medical Billers in 2025

Final Thoughts

Understanding the difference between CPT and ICD-10—and knowing when and how to look them up—is essential for accurate, fast, and clean medical billing.

• CPT = What was done

• ICD-10 = Why it was done

Investing in the right CPT and ICD-10 lookup tools helps medical billers reduce denials, improve cash flow, and stay compliant.