Tuesday, 28 October 2014

Cpt Codes Exist To Facilitate Medical Billing

By Patty Goff


There are so many complicated procedures in the medical field that it makes billing difficult. All the illnesses, procedures and medicines have complicated names. The individual who is qualified to work as a coder will have to be familiar with the Current Procedural Terminology or cpt codes to perform those duties.

There is a panel of experts overseeing the application of them called The CPT Editorial Panel. They perform under the directions of the AMA. The code is nd protected under the auspices of that organization.

The coding system was devised to facilitate clarity in the communications sent from one medical expert to another department. There are separate ones to identify surgical procedures, diagnostic services and general medical procedures.

There are three types of CPT code, which differentiates between procedures. These are Category I, Category II and Category III. Some examples of the first category are outpatient care, Home health care and in-patient care in a retirement home.

They are item specific. One category applies to the administration of anesthesia. Each body part that is being operated on uses a separate code. Some examples include the extremities, the head and the eyes.

Individual numbers assigned to surgical services may include pelvic, reproductive system and auditory system. To make the billing very specific, a cochlear implant surgery is classified under auditory system. Billing is rendered less complicated when used in the bills sent out to the patient.

Radiology includes diagnostic ultrasound, radiation oncology and mammography. The mammogram is most often a routine check for breast cancer. It is administered by a nurse and read by a physician.

Pathology and laboratory are another category. Included are drug tests, evocative suppression testing and the simple urinalysis administered as part of any routine exam in the physicians office. Complicated testing includes hematology and coagulation, transfusion medicine and the postmortem anatomic pathology.

Routine vaccinations, administration of immunizations and kidney dialysis treatments fall under the numbers for medicine category. When someone has severe kidney disease, the dialysis keeps that person alive until a replacement kidney is matched to their blood type. A kidney transplant will relieve them of the need for dialysis.

This same classifications for medicine include psychiatry, special otorhinolaryngologic services and noninvasive vascular diagnostic studies. The otorhinolaryngologic specialist is also known as an ear, nose and throat man or woman.

Under category II the codes include a letter of the alphabet as the fifth character in the code. For example, you will find four digits and then an alphabetical character. The eleven category II codes include physical examination, diagnostic screening processes or the results and patient history.

Psychotherapy and other counseling services are in Category III. It does not include psychiatric counseling. Some of the numbers are retired when experts feel they are no longer needed. They are evaluated on a yearly basis.

It is true that CPT is a copyright protected registered trademark belonging to the American Medical Association. However, its use is not limited to that organization. It is used by other health care organizations. Some examples are the Centers for Medicare and Medicaid, and the Federal Register. Each pays a licensing fee to entitle them to utilize the code.




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