Laura Gray
University of Phoenix - Axia
July 14, 2011
CPT Buzzwords Know Your Categories. The CPT has three categories to it. Each category contains its own codes and has its own role in the medical billing. To help you determine which section you are going to use, I have made the following buzzwords for each section. Category I is the most important category of the CPT Process. We will use this section for all billing situations. Because this is the most important section we are going to consider it the heart of our billing world. Just like our bodies can’t function without our heart, a billing specialist can’t function without section 1. Section one has the codes from routine dr. visits, Surgery procedures, Radiology, Lab, Medicine, and Anesthesia. Example of codes and procedure that would be located in section one: Established patient (EP) has x-ray of ankle w/three views, surgery is decided. The CPT codes used would be EP problem focused 99212-57 (modifier 57 is used because of surgery decision). X-ray 73610. Surgical procedure - Open treatment of a bimalleolar fracture 27814. The second Category of the CPT is not used for billing, but for measuring medical goals. These are issues that dr. may discuss with patient to help them reach healthier goals. This section we are going to refer to as our bloodline. We don’t want any germs getting into our blood and making us sick. This is the section that has information for keeping us healthy. Example: discussed tobacco use, smoking assessed code 0002f, Tobacco use, cessation, intervention counseling code 0004f. The third category is used for Temporary codes for new technology services and procedures. This section we are going to call our brain section. We use our brain to learn new things. With this being the section for new procedures we go here to feed the brain new information. Example of code in this: 0041T Urinalysis infectious agent detection.
References
References: Valerius, J., Bayes, N., Newby, C., Seggern, J., (2008). Medical Insurance (3rd ed.). New York, NY: McGraw Hill. www.sgvdiagnostic.com/pdf/ http://thousand-cranes.com/wordpress/?tag=27814