What is CPT in Medical Coding?

Introducion of CPT in Medical coding

Current Procedural Terminology (CPT) is a group of codes that is used to report medical procedures and services to entities such as physicians, health insurance companies and accreditation organizations. CPT are use in conjunction with ICD-9-CM or ICD-10-CM numerical diagnostic coding during the electronic medical billing process.

Read also: When to code SELECTIVE cpt code for angiogram

CPT codes categories in Medical coding

Category I CPT codes describe a procedure or service identified with a five-digit CPT code and descriptor nomenclature.
Category II CPT Codes are supplemental tracking alphanumeric codes that can be used for performance measurement. The use of these codes is usually optional; the codes are not required for correct coding and may not be used as a substitute for Category I codes
Category III CPT Codes are temporary codes for new and emerging technology, procedures, and services. They have been created to allow data collection and assessment of new services and procedures.
Modifiers are sometimes assigned to these codes to modify the CPT codes which alter the dollar value.
CPT is a registered trademark of the American Medical Association.Medical coding as a career and certification exams


CPC Practice Exam - Medical Coding Study Guide Please Click Here!


Importance of CPT codes in Medical coding

The purpose of the coding system is to provide uniform language that accurately describes medical, surgical, and diagnostic services. A CPT code is a five digit numeric code that is used to describe medical, surgical, radiology, laboratory, anesthesiology, and evaluation/management services of physicians, hospitals, and other health care providers. There are approximately 7,800 CPT codes ranging from 00100 through 99499. It is published in two versions, the first is the most common, CPT Physician’s Current Procedural Terminology. A second publication is also available the CPT Physician’s Current Procedural Terminology Specially Annotated for Hospitals. The Hospital version contains all the information in the original version with the addition of special Medicare guidelines and notations for identifying criteria applicable to outpatient hospital billing.
The rules for assigning the appropriate code are complex, and so we advise individuals who are determining the appropriate codes receive the proper training and credentials. This would include any office or clinic personnel who play a significant role in coding.
What is an ICD-9 Code?
ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) coding system is used to code signs, symptoms, injuries, diseases, and conditions.
The relationship between ICD-9 (diagnosis) and CPT (procedural) Codes
The relationship between an ICD-9 code and a CPT code is that the diagnosis should support the medical necessity of the procedure. Since both ICD-9 and CPT are numeric codes, health care consulting firms, the government, and insurers have all designed software that compares the codes for a logical relationship. For example, a bill for CPT 71020, chest x ray 2 view would not be supported by ICD-9 824.8, closed fracture of a ankle. Claims having diagnosis not supported with CPT procedure code get denied quickly.


Share this

Related Posts

Previous
Next Post »