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.

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.

This code was created to make clear what was administered to each patient in the communications transmitted from one medical department to another. Separate ones identify diagnoses, surgeries and all other medical processes.

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.

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.

Pathology and laboratory are another category. Included are drug tests, evocative suppression testing and the simple urinalysis administered as part of any routine exam in the physicians office. Complicated testing includes hematology and coagulation, transfusion medicine and the postmortem anatomic pathology.

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.

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.

It is true that CPT is a copyright protected registered trademark belonging to the American Medical Association. However, its use is not limited to that organization. It is used by other health care organizations. Some examples are the Centers for Medicare and Medicaid, and the Federal Register. Each pays a licensing fee to entitle them to utilize the code.




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