Cpt Codes Exist To Facilitate Medical Billing

By Patty Goff


Medical billing is a complicated position that requires training. There are a myriad of procedures, medications and illnesses with difficult to spell names. A coder must know the Current Procedural Terminology, known as the cpt codes to function in that position.

Experts sitting on a panel, the CPT editorial panel, oversee the administration of the coding. Of experts exists called the CPT Editorial Panel. They work under the auspices and direction of the AMA. There is a copyright owned and protected by that august 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.

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.

Numbers in Category II have four numbers followed by an alphabetical letter to identify them. This classification contains eleven codes. Included are routine physical exams, diagnostic screenings and taking the patients medical 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.

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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