medical coding

Current Procedural Terminology or CPT-4
CPT was develped by
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?
3 editions were developed and published in what yr.
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
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
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
summary of cpt codes that are modifier 63 infants
appendix G
summery of moderate conscious sedation codes (bulls eye)
alphabetic index of performance measures by clinical condition or topic & list catagory 11 codes
lists the genetic testing modifiers
diagnotic medicinne listing of sensory, motor and mixed nerves
pending FDA approval
L, M
vascular families; deleted cpt codes
how many sections of the CPT
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
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
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
what does the term (see) mean
it is a cross reference term found in the index