Cpt Codes Are Used To Facilitate Medical Billing

By Patty Goff


Medical billing can be a complicated endeavor. There are a high number of illnesses, surgeries and much information to remember. The person who functions in this medical position will use the Current Procedural Terminology or cpt codes, on a regular basis.

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.

ICD-10 coding identifies the illness or condition a patient is suffering from. Three types of CPT code exist, identified as Category I, Category II and Category III. In Category I you will find six sections. Some examples of Category I are Office or outpatient, Critical care and Home health care services.

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.

The individual code numbers for surgical procedures include integumentary system, reproductive system and auditory system. The now successful cochlear implant surgery would be classified under auditory system. As you can see, this makes billing run smoothly.

Radiology includes diagnostic ultrasound, radiation oncology and mammography. The mammogram is most often a routine check for breast cancer. It is administered by a nurse and read by a physician.

Another classification is for laboratory codes and pathology examinations, also known as autopsy examinations. These, of course, are done post-mortem. Some brain diseases can only be confirmed after the patient has died. Transfusions also fall in this category.

The ones for the category named medicine include routine vaccinations, administering those immunizations and treatments for kidney disease, which are transfusions to clean the blood. It is dialysis that maintains the patients life while they wait for a kidney transplant. After that, if successful, they will no longer require dialysis treatments.

Specialists also fall under the class of those used for medicine. Some specialties include otorhinolaryngology, psychiatry and cardiology. The cardiologist is known as the heart doctor and the otorhinolaryngologist is, in laymans terms, an ear, nose and throat doctor.

Under category II the codes include a letter of the alphabet as the fifth character in the code. For example, you will find four digits and then an alphabetical character. The eleven category II codes include physical examination, diagnostic screening processes or the results and patient history.

Category III codes include those for psychotherapy and other counseling. Some will be retired as of 2014. However psychological testing codes will not be changed. Codes are re-evaluated on an annual basis.

The American Medical Association owns the registered trademark and the copyright belongs to them. They license it out to other medical organizations for their use. The Centers for Medicare and Medicaid, and the Federal Register make use of these codes to make their billing work function smoothly.




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