Saturday 25 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 who oversee maintenance of the medical code under the direction of the American Medical Association. It is called the CPT Editorial Panel. It is copyright protected by the AMA.

The code facilitates clarity in communication from one medical department to another. It covers descriptions of diagnostic, surgical and medical care for coders. It identifies what service a patient is being billed for.

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.

There are specific ones for the administration of anesthesia. Each code refers to a body part or type of procedure. For example, upper or lower abdomen, radiological procedures and neck are each assigned their own code.

Each surgery has a separate number to identify it. For example, surgery to the reproductive system, repairing a deviated septum and a cochlear implant would each be assigned a number. This makes a bill easier for the patient and insurance carrier to understand.

There are those for radiology, which include treatments of radiation oncology, mammograms and ultrasound tests. Pregnant women can be reassured that the baby is healthy. It is often possible to identify if the baby is a boy or girl.

Another category is pathology and laboratory. Drug testing, a simple urinalysis and various testing of the blood fall under this category. Transfusions are included. The postmortems, also known as autopsies, are classified here.

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.

Treatments by medical specialists come under the class of those indicating medicine. The specialists can be board-certified in psychiatry, cardiology or otorhinolaryngology. The psychiatrist treats the mind, the cardiologist the heart and the otorhinolaryngologist, the ears, nose and throat.

They include a letter of the alphabet to indicate they belong in Category II. There will be four numbers and then a letter of the alphabet. There are eleven Category II codes that include diagnostic screenings, taking a patient history and physical examination.

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.

Although the AMA is the owner of both the registered trademark and the copyrights to the CPT code, they share it with other medical facilities. Some are The Federal Register and the organization that bills for Medicare and Medicaid. Each is required to pay for a license that entitles them to use it. It makes their billing systems run smoothly.




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