Diagnosis Code

Código de diagnóstico

In 9 languages

LanguageTerm
EnglishDiagnosis Code
Spanish (Español) Código de diagnóstico
Chinese (中文) 诊断代码
Korean (한국어) 진단 코드
Vietnamese (Tiếng Việt) Mã chẩn đoán
Filipino (Tagalog) Diagnosis code
Portuguese (Português) Código de diagnóstico
Thai (ภาษาไทย) รหัสวินิจฉัย
Japanese (日本語) 診断コード

What it means

A diagnosis code identifies a patient's medical condition on insurance claims and clinical records. In the United States, diagnosis codes follow the ICD-10-CM system. Every claim submitted to a US insurer must include at least one diagnosis code that justifies the medical necessity of the service. Codes are assigned by the treating provider based on the documented diagnosis, not symptoms alone. Incorrect or unsupported diagnosis codes are a common cause of claim denials.

How to say it

Sentences a patient might use with a doctor, nurse, pharmacist, or insurer:

My claim was denied because the diagnosis code did not support the procedure that was billed.

Mi reclamo fue rechazado porque el código de diagnóstico no respaldaba el procedimiento que se facturó.

Can you tell me which diagnosis code was submitted to my insurer for this visit?

¿Puede decirme qué código de diagnóstico se envió a mi aseguradora por esta visita?

The provider must use the correct diagnosis code to show medical necessity for my MRI.

El proveedor debe usar el código de diagnóstico correcto para demostrar la necesidad médica de mi resonancia magnética.

Where you'll see it

Explanation of Benefits (EOB)Insurance claim form (CMS-1500)Medical billElectronic health record (EHR)

Related terms

Sources

US Glossary Español A–Z US Codes United States

Last reviewed: September 2026