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CPT

Current Procedural Terminology or CPT-4

CPT was develped by

AMA

WHAT DOES THE CPT DO ITS FUNCTION

converts descriptions into 5 digit number codes

who uses the cpt coding system

clinics, outpatient hospital departments, ambulance surger centers, third party payers , everyone

History of coding : CPT was developed and published by the AMA in what year?

1966

3 editions were developed and published in what yr.

1970"s

what does CMS stand for?

Centers for Medicare & Medicade services

what was the CMS formly called

Health care financing administration (HCFA)

What does HCPCS stand for

Healthcare common procedural coding system

what does the HCPCS do

provides codes of reporting services, procedures and supplies

How many level of codes

2

what does Level 1 do?

Defines the professional service

what does level 2 do

National codes that are alphanumeric and used by providers to report services, supplies and equipment provided to medicare and medicaid patients for which no CPT codes exist

How often are CPT manuals updated

yearly

what does this symbol (.) stand for

new codes for procedures

what does a triangle stand for

change or modified codes .

what does a triangle going rt and left indicate

the beginning and end of text changes

what does a + sign mean

an add on.

ad on codes are never used alone how are they used

with another primary procedure of service code

a circle with a line through it indicates what

a modifier symbol indicates that more than one procedure was performed

Appendix A

lists all modifiers used to alter or modify codes

appendix B

complete list of additions, deletions and revisions

appendix c

clinical examples of many of the Evaluation & management (E/M) codes

appendix d

list all add ons

appendix E

contains the list of modifiers-51

F

summary of cpt codes that are modifier 63 infants

appendix G

summery of moderate conscious sedation codes (bulls eye)

H

alphabetic index of performance measures by clinical condition or topic & list catagory 11 codes

I

lists the genetic testing modifiers

J

diagnotic medicinne listing of sensory, motor and mixed nerves

k

pending FDA approval

L, M

vascular families; deleted cpt codes

how many sections of the CPT

6

WHAT ARE THE CHAPTERS CALLED

sections

what are the 6 sections of the CPT manual

Evaluation and management, anesthesia, surgery, radiology, pathology and lab, medicine

sections of the CPT are devided into

subsections

subsection subheadings, categories and subcategories are divisions of sections that are based on

anatomy, procedure, condition, description or approach

what are guidelines?

guidelines provide specific information about coding in that section

where are guidelines found

at the beginning of each section

guidelines and notes contain

definitions of terms, modifiers, subsection information, unlisted services, special report information or clinical examplesk

there are ? types of codes

2

what are the types

stand alone codes and indented codes

stand alone code is

gives full description

indented codes

listed under associated stand alone codes

what does the semi colon mean

a critcal clue it is understood that descriptions for indented codes include the portion of the stand alone code description

what are modifiers

they provide additional information to the third party payer about services

what are the most common modifiers

62 and 51

how many digits do modifiers have and where are they added

2 digit that are added to the 5 digit CPT code

what are unlisted procedures

any procedure that is not listed in the manual can be coded as an unlisted procedure

where is the unlisted procedure listed

at the end of the subsection or subheading where they are referenced

what are special reports

they musb be included with claims when unusual new seldom used unlisted or category 111 procedure is performed

where does the special report go

always include definition/description of the nature, extent and need for the procedure. the time effor and equipment necessary to provide the service

where is the CPT index located

at the back of the CPT manual

what is a single code

only one code

multiple code?is indicated by what sign

use comma

range of codes is indicated by what a

hyphen

what does the term (see) mean

it is a cross reference term found in the index

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