Medical Billing & Insurance Coding: Unlocking The Mystery of CPT Coding
Medical Billing & Insurance Coding: Unlocking The Mystery of CPT Coding
Medical Billing & Insurance Coding: Unlocking The Mystery of CPT Coding
What is CPT?
The Current Procedural Terminology
coding system or CPT is a registered
trademark of the American Medical
Association (AMA) and is copyrighted by
the physicians organization.
The code sets are HIPAA compliant for
procedures and services provided by
physicians, ambulatory surgical centers
(ASCs), and hospital outpatient (OP)
services.
Double Check
Go back to your report or medical chart
Modifiers
Modifiers more fully describe the
postop period
-25 Additional E/M service on same day as
office procedure by the same physician
-26 Professional Component
-32 Mandated Service
-47 Anesthesia by surgeon
procedure
-62 Two surgeons
-80 Assistant surgeon
Unlisted Codes
Unlisted codes are at the end of each CPT
CPT vs HCPCS
Level I= CPT developed by the AMA
Level II = HCPCS National Codes (A-V)
Additional codes & modifiers to report nonphysician medical services and supplies to
Medicare & Medicaid
Level III = Local HCPCS codes (W-Z)
Codes assigned & maintained by your local
Medicare carriers
HCPCS codes are alphanumeric
Management Association
(AHIMA; www.ahima.org)
AHIMA is committed to lifelong learning
in HIM; certification distinguishes an
individual as competent,
knowledgeable, and committed to
quality healthcare through quality
information.
Classroom Assignment
Count off 1, 2, and 3 and move into
three groups.
Using the CPT coding books provided,
each group will look up the following
procedure or service that corresponds
with the number of your group in the
index and write the proper code from
the numeric section on a piece of paper.
Coding Assignment
1. Manual therapy techniques, 1 or more
Answer Key
1. 97140 manual therapy techniques, 1