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Misc. CPT Info
Terms in this set (82)
Very important heading in CPT index. Tumor is also an option, but lesion is often better.
Modifier that indicates multiple procedures.
Sometimes the same code is listed twice to show it was done more than once, ie. 2 different lesions removed by same method.
If multiple lesions removed, largest excision of lesions would be listed first.
Full Thickness Skin Graft
Sometimes additional codes need to be added to indicate more skin was grafted.
No E/M Code
Some CPT codes include E/M in the procedure.
Important CPT index heading that will have body parts listed like joint. Within chapter, joint is further broken down into subcategories like "major joint".
Important CPT index heading for term that means removal of part of something.
A CPT index heading that you wouldn't automatically think of looking under for some things. It is a body region that has things listed under it like tumor and then excision.
Important CPT index heading. It has listings like hip and hip joint, which are considered two different things.
Sometimes this term isn't used but is assumed because no incision is mentioned.
Moderate conscious sedation has its own codes. Look under sedation and then moderate.
Over/Under age 5
Lots of codes will make a distinction between whether a procedure was done on someone over or under the age of 5 years old.
Sometimes code needed to indicate a different physician is involved, such as one who is doing MCS but not the actual operation.
Time of MCS
There are codes for adding 15 minute increments of MCS.
Central Venous Catheter Placement
Important CPT index heading. Options under it like insertion and then peripheral.
Considered a central vein in terms of CVCP.
Considered a peripheral vein in arm that is often used for CVCP.
Ultrasound is an important CPT index heading that has guidance under it and then more specific options like vascular access.
Modifier that means professional component.
Modifier to indicate right side.
Modifier to indicate left side.
Has its own CPT index heading, but the cardiovascular chapter then has specific codes for things like multiple veins injected with sclerosant in the same leg.
Important CPT index heading which has things like graft under it.
Example of something that would have a code for 2 veins involved in one procedure.
Procedures involving this artery are often listed first, since it is considered a more important blood vessel than other kinds of blood vessels.
Cardiac Assist Devices
Important heading in CPT index that has things like pacemaker listed under it.
Within chapter, read carefully about different pacemakers. Some are single or dual chamber. Some have one or more lead wires.
Has its own CPT index heading with options under it like tumor. Hint: a type of gland.
When procedures involving crucial nerves, read carefully whether the code says nerve was preserved or was involving a lateral lobe.
If question mentions that procedure involves Medicare patient, check HCPCS book.
Example of code also listed in HCPCS for Medicare patients with high risk history to justify the procedure being done more often.
Has its own CPT index heading but refers you to anoscopy and then biopsy under that.
Has its own CPT index heading with body parts under it such as prostate.
Sometimes need to read codes carefully within chapter to see which one mentions something like electrosurgery.
Important CPT index heading for a procedure to check for cancer with various body parts under it.
Within chapter, read carefully about whether single or multiple approach or whether it has a note about adding a code for something like ultrasound guidance.
Codes within chapter to list it as standalone procedure or as part of pre and postnatal care.
In case of twins, would be listed first if other born vaginally, since it is considered more complex.
When twins are delivered, only code once for pre and postnatal care, as they are considered a unit.
Ear related and has its own CPT index heading.
Sometimes a code will say it already includes general anesthesia, so no separate code for general anesthesia needed.
Important CPT index heading involving use of a needle. It has various body parts under it and then further options for things like "with image guidance".
Spinal injections sometimes involve more than one level of spine. Pay attention to distinguishing those codes.
Example of something that is sometimes already included in certain codes so that it doesn't need a separate code.
Spinal procedure that has its own CPT heading which may then have other procedures listed under it that were also done.
Pay attention to whether you need to have different codes for procedures done on different spinal levels.
Pay attention within chapter to whether codes correspond to cervical, thoracic, or lumbar spine.
Important section within E/M chapter for emergencies.
Nursing Facility Services
Important section within E/M chapter for nursing homes.
Be careful not to up code E/M services to involve more complex decision making or exams/history.
Important part of E/M chapter. Critical care such as CPR performed in ER is still considered outpatient because patient hasn't been admitted to inpatient. Same is true for critical care performed in an ambulance. Age of patient does not matter.
Additional procedures performed during encounter.
Emergency procedure that has its own heading in CPT index.
Important CPT index heading involving tubes.
With critical care, codes are often listed separately and not bundled as one critical care encounter.
Has its own CPT index heading as a method of drawing blood.
Common Blood Panels
At beginning of Pathology and Laboratory chapter, there is a section that lists different codes for common blood panels, such as an electrolyte panel.
Important CPT index heading that lists various body parts but also things like shunt. Pay attention to whether questions is only asking for an anesthesia code. Anesthesia code chapter gives instructions for coding the length of anesthesia (CPT code; XX minutes).
An code option within Eye chapter.
Anesthesia add on code for patients over 70 years of age. Listed at beginning of anesthesia chapter.
Has its own CPT index heading with various body parts under it. Within chapter, there will then be details about contrast and sequences.
Common procedure for women that has its own CPT index heading with more specific descriptions under it.
Urinary system procedure that has its own CPT index heading.
Radiological Supervision and Interpretation
Sometimes within a chapter, there will be a note to add another code that indicates radiological supervision and interpretation.
In Office Procedures
Often do not have extra modifiers.
Pathology and Laboratory
Important CPT index heading. An important subheading is Surgical Pathology and then gross/micro.
Total creatinine kinase- has its own heading in CPT index with blood listed under it.
Modifer for additional tests, usually meaning on blood.
x 2 units
Way of describing additional blood tests after a modifer of 91.
Has its own CPT index heading with options like IV under it. Usually first hour of hydration infusion has one code but then other codes can be added to show time greater than an hour.
HCPCS has codes related to how much saline solution used in an infusion.
Important CPT index heading. Will often add something like x2 for how many allergans tested.
Important CPT index heading. Within chapter, choose code distinguishing whether doctor provided the serum and did the injection or just did one of those things.
Has its own CPT index heading. If no mention of incision, assumed to be external.
Example of a blood vessel that you might want to look up in Appendix L of CPT book, which has charts of vascular families.
Example of something found in HCPCS. Read options very carefully, as some codes relate to the tray for it and others for the actual catheter. Check if question is just asking for supplies for the Foley Catheter. Check whether silicone or some other material.
Example of a drug that you would look for in Table 1 of HCPCS, but many drugs listed in that table.
Only really considered "with contrast" if the contrast is introduced intravenously, not orally.
THIS SET IS OFTEN IN FOLDERS WITH...
Category 1 CPT Code Sections (mostly surgical)
Category 2 and 3 Codes and CPT Appendices
HCPCS Level II Codes and Appendices
Category 1 CPT codes that begin with 9 except for…
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ICD-10-PCS Tables 0B1-0Y0
ICD-10-PCS Tables 001-090